子宫切除术与上皮性卵巢癌相关性临床研究

Correlation of Hysterectomy and Epithelial Ovarian Cancer

摘要: 目的：探讨子宫切除术与散在上皮性卵巢癌(EOC)患病风险的关系；方法：采用以住院患者为基础的病例对照研究，选取青岛大学附属医院2015-01-01~2021-01-01间首次确诊的原发性EOC患者974人作为病例组和985名年龄相匹配的同期住院非卵巢癌患者作为对照组，将2组的一般情况、病例特点和既往子宫切除情况进行比较；结果：2组患者的体重指数、月经初潮年龄、绝经年龄、产次、服用口服避孕药和吸烟等因素比较差异均无统计学意义，均P > 0.05；病例组的子宫切除术(OR = 1.748, 95% CI 1.224~2.498, P = 0.028)发生率均高于对照组，差异有统计学意义；2组患者子宫切除术的手术路径比较差异有统计学意义(χ² = 9.083, P = 0.011)；对于既往是否行子宫切除术，II型EOC的既往子宫切除率明显高于对照组(OR = 1.850, 95% CI 1.286~2.660, P = 0.001)，差异有统计学意义；结论：子宫切除术可能增加患EOC的风险，主要增加II型EOC患病风险。开腹子宫切除术比腹腔镜、经阴手术的影响或许更为显著。

Abstract: Objective: To investigate the relationship between hysterectomy and the risk of in sporadic epithe-lial ovarian cancer (EOC). Methods: In a case-control study based on hospitalized patients, 974 pa-tients with primary EOC diagnosed for the first time in the Affiliated Hospital of Qingdao University from 1 January 2015 to 1 January 2021 were selected as the case group and 985 age-matched non-ovarian cancer patients as the control group. The basic conditions and previous hysterectomy of the two groups were compared. Results: There was no significant difference in terms of body mass index, menarche age, menopause age, parity, taking oral contraceptives and smoking between the two groups (P > 0.05). The incidence of hysterectomy (OR = 1.748, 95% CI 1.224~2.498, P = 0.028) in case group were higher than the control group, the difference was statistically significant. There was significant difference in hysterectomy surgery path between the two groups (χ² = 9.083, P = 0.011). For hysterectomy, there was significant difference between Type II EOC and the control group (OR = 1.850, 95% CI 1.286~2.660, P = 0.001). Conclusion: Hysterectomy may increase the risk of EOC and mainly increase the risk of Type II EOC. The effect of open hysterectomy is more sig-nificant than that of laparoscopy and transvaginal surgery.