摘要
目的:系统评价绝经期妇女激素替代治疗与宫颈癌发病风险的相关性。方法:检索Pub Med、Em Base、Web of Science、CNKI、维普及万方数据库,搜集有关绝经期妇女激素替代治疗和宫颈癌发病风险相关的研究,检索时间截至2017年11月1日。由2位研究者独立筛选并纳入相关文献,提取文献数据。采用STATA12.0统计软件进行Meta分析,以比值比(OR)及95%置信区间(95%CI)作为效应量,异质性检验评估使用统计量I2;敏感性分析判定结果的稳定性;发表偏倚使用漏斗图、Begg秩相关和Egger线性回归法。结果:最终纳入10篇研究,样本量680235例,其中病例组4312例,对照组675923例。Meta分析结果显示,绝经妇女激素替代治疗与宫颈癌的发病无相关性(OR=0.85,95%CI为0.55~1.31,P=0.467)。根据文献研究类型、种族和激素替代治疗方案的不同进行亚组分析,结果显示:在队列研究、病例对照研究和随机对照研究中发现激素替代治疗与宫颈癌的发病无相关性(OR分别为0.35、0.71、1.48,P=0.41、0.07、0.36);分别对欧洲、亚洲和北美洲人群进行分析发现激素替代治疗与宫颈癌的发病风险无相关性(OR分别为0.59、0.90、1.29,P=0.16、0.80、0.33);绝经妇女不论是使用雌激素还是雌孕激素联合治疗均未发现激素替代治疗会增加宫颈癌的发病风险(OR分别为0.81、0.83,P=0.59、0.39)。结论:绝经妇女使用激素替代治疗不增加宫颈癌的发病风险,结果不受研究类型、种族和激素替代治疗方案的不同而变化。
Objective： To evaluate the correlation between hormone replacement therapy in menopause women and the risk of cervical cancer. Method： A computer-based online search was performed by using Pub Med、Em Base、Web of Science、China National Knowledge Infrastructure（ CNKI） 、VIP and Wanfang databases. The references of hormone replacement therapy in menopause women and the risk of cervical cancer were searched. Two authors independently screened literature according to the inclusion and exclusion criteria and extracted data.The Meta-analysis was performed using STATA 12.0 software.The outcome measures were the odds ratio（ OR） and 95% confidence intervals（ 95% CI）. I2 was performed in a heterogeneity assessment.Publication bias was evaluated by using Begg＇s funnel plot and Egger＇s test and the sensitivity analysis was conducted to confirm robustness. Results： We identified 10 eligible surveys with a total population of 680235,of which 4312 were in case group and 675923 in control group.The meta-analysis showed that hormone replacement therapy in menopause women was not associated with the incidence of cervical cancer（ OR = 0. 85,95% CI 0. 55 ~ 1.31,P = 0.467）.Subgroup analysis had shown,it was not found that hormone replacement therapy was related with the incidence of cervical cancer in cohort study,case-control study and randomized controlled study（ OR = 0.35、0.71、1.48,P = 0.41、0.07、0.36,respectively）,nor was in Europe,Asia or North America（ OR = 0.59、0.90、1.29,P = 0.16、0.80、0.33,respectively）. Hormone replacement therapy（ estrogen or estrogen and progesterone） could not increase the risk of cervical cancer in women with menopause（ OR = 0. 81、0. 83,P = 0. 59、0. 39,respectively. Conclusion： Hormone replacement therapy for postmenopausal women don＇t increase the risk of cervical cancer,and the result is not affected by the different types of studies,race and treatment plan.
作者
万凤知
周容
王月君
Wan Fengzhi;Zhou Rong;Wang Yuejun(Yichang Central People＇s Hospital of the First Clinical Medicine Hospital of China Three Gorges University, Yichang 44300)
出处
《现代妇产科进展》
CSCD
北大核心
2018年第4期268-272,275,共6页
Progress in Obstetrics and Gynecology
关键词
宫颈癌
激素替代治疗
META分析
Cancer of the cervix
Hormone replacement therapy
Meta-analysis
