卵巢癌患者发病危险因素及术后康复效果影响因素分析

目的对卵巢癌患者发病的危险因素和治疗后康复效果的影响因素进行相关分析,从而为卵巢癌的预防和治疗提供一定的依据。方法选取我院2013年1月至2017年1月收治的358例卵巢癌患者作为观察组,选取同阶段在我院门诊确诊为非恶性肿瘤的女性患者358例作为对照组,收集两组患者的年龄、婚姻状况、民族分布、既往病史、妊娠史、流产史等一般临床资料和相关资料,采用病例对照研究、方差分析、单因素分析和多元回归分析等方法对其进行统计分析,探讨影响卵巢癌患者发病的危险因素。结果病例比较结果显示,卵巢癌的发病与年龄、婚姻状况和民族分布无关;单因素分析结果显示,卵巢癌发病的危险因素有初潮年龄、自然流产、人工流产、月经期、痛经、妊娠次数;多因素分析结果显示,卵巢癌发病的主要危险因素为人工流产(OR=2.3 61,P=0.002)、自然流产(OR=2.197,P0.001)和月经期(OR=3.413,P0.001)。Cox风险回归模型的分析结果显示,卵巢癌术后康复效果主要与FIGO分期、术后残存病灶大小和CA_(125)下降水平有关(P0.05),与年龄、组织学分型和分化程度无关(P0.05)。结论通过对卵巢癌的发病危险因素和术后康复效果的影响因素进行分析,采取相应的改善措施,一方面预防卵巢癌的发生,另一方面改善已经发生卵巢癌的患者的预后。     

女性乳腺癌危险因素的病例对照研究

目的探求女性乳腺癌的危险因素,为乳腺癌的防治提供依据。方法采用病例对照研究方法,问卷调查2003年1月~2005年4月入院的经病理组织学确诊的女性乳腺癌生存病例及同时段入院的外伤患者。利用SPSS进行数据录入和分析,用logistic回归模型进行单因素和多因素分析筛选出有意义的危险因素。结果经单因素及多因素分析,与乳腺癌发病有关的因素为:月经经期不规则、行经期长、流产史、青霉素过敏史等,月经初潮晚能降低乳腺癌的发病风险。结论月经经期不规则、行经期长、流产史及青霉素过敏史等是乳腺癌危险因素,而月经初潮晚对乳腺癌有保护作用。     

子宫肌瘤患者危险因素的病例对照研究

目的研究长春市子宫肌瘤患者发病危险因素。方法以2005年9月—2008年9月在长春市某三甲医院就诊的160例经病理学检查确诊为子宫肌瘤的患者作为病例组,同期在该医院进行诊查的158例非子宫肌瘤妇女作为对照组。按照病例-对照研究设计对所有研究对象进行流行学调查,获取基本信息、月经史、生育节育史、既往与现病史等资料。应用Excel、SPSS12.0软件进行Logistic回归等统计学分析。结果子宫肌瘤患者年龄多集中在31～50岁之间,以41～50岁的妇女最为多见,占患者总数的46.88%。单因素分析显示,多次人工流产会导致子宫肌瘤发生的危险性增加,OR(95%CI)为1.754(1.115～2.759)。非条件Logistic回归分析显示,初潮年龄、妊娠次数、流产次数与子宫肌瘤有关,OR(95%CI)分别为0.114(0.038～0.342),1.900(1.065～3.388),14.681(4.374～49.281)。结论初潮年龄早、妊娠次数多、流产次数多可能是子宫肌瘤发病的危险因素。     

乳腺癌的病例对照研究

目的进一步探讨和证实乳腺癌的危险因素。方法对上海市１３４名乳腺癌患者进行了１∶１配对的病例对照研究。结果月经初潮年龄、是否怀孕、初产年龄、是否哺乳、良性乳腺病、乳腺癌家族史、教育年限、行经期等危险因素与乳腺癌的发生有关。多因素条件Ｌｏｇｉｓｔｉｃ回归分析显示月经初潮年龄、初产年龄、良性乳腺病、乳腺癌家族史等因素最终进入模型。进一步对乳腺癌病人进行绝经前后的分组分析,绝经前乳腺癌的危险因素包括月经初潮年龄、初产年龄、良性乳腺病,而绝经后危险因素则包括初产年龄、行经期和体重。因素之间经检验无两两交互作用。结论提示绝经前与绝经后乳腺癌在发病上存在一定差异,但需要进一步的研究加以证实。     

子宫内膜癌患病的危险因素Logistic回归分析

目的:探讨金坛市子宫内膜癌发病的危险因素。方法:采用病例对照研究,选择2005年12月～2011年6月在金坛市人民医院妇产科就诊并经过病理诊断为子宫内膜癌的患者165例为病例组,同时选择528例健康体检者为对照组,采用单因素与多因素非条件Logistic回归分析子宫内膜癌发病的危险因素。结果:单因素分析表明,年龄≤50岁、年龄≥61岁、BMI超重、患有高血压、患有糖尿病、月经初潮年龄≤12岁、初次分娩年龄≤20岁、一级亲属中有乳癌、子宫内膜癌、结肠癌、卵巢癌患病史与子宫内膜癌发病有关。通过多因素Logistic逐步回归分析,最终引入回归方程的变量为年龄≤50岁、年龄≥61岁、BMI超重、患有高血压、患有糖尿病、月经初潮年龄≤12岁、一级亲属中有结肠癌及卵巢癌患病史。结论:年龄≥61岁、BMI超重、患有高血压、患有糖尿病、月经初潮年龄≤12岁、一级亲属中有结肠癌及卵巢癌患病史是子宫内膜癌发病的危险因素,年龄≤50岁是子宫内膜癌发病的保护因素。     

卵巢癌高危险因素的病例—对照研究

本文对原发性卵巢上皮癌(卵巢癌)发病的高危险因素进行配对研究。共选用卵巢癌病例62例,对照124例。详细了解病例和对照的月经史、生育史、嗜好和某些病毒的感染情况等发现月经不规则,不育和孕次较少及流行性腮腺炎病毒感染可能与卵巢癌发病有关。怀孕次数少患卵巢癌的相对危险度较大。趋势性检验(2×c表),差别也显著(χ²=10.07,P<0.05)。提示妊娠可能是卵巢癌保护因素之一。对月经初潮、停经、初产和结婚年龄、以及家族肿瘤史、高血压和烟、酒嗜好等因素也进行了调查分析,未能证实这些因素与卵巢癌发病有关。     

天津市婴幼儿孤独症患病率与危险因素

目的:探讨天津市婴幼儿孤独症的患病率及相关危险因素,为今后孤独症病因研究提供线索。方法:应用巢式病例对照研究方法,按分层整群抽样的原则随机抽取天津市7 904名1.5～3岁的儿童进行孤独症筛查,对412名筛查阳性儿童进行追踪,年龄满3岁时进行孤独症确诊;每个病例按相同性别月龄匹配4例对照,因素调查表分为四部分,每部分分别进行单因素及多因素条件Logistic回归。结果:22例确诊为孤独症,天津市婴幼儿孤独症患病率及其95%的可信区间为27.83/万(16.22/万～39.44/万),男性孤独症患病率是女性的4倍(P<0.05)。单因素分析时发现孤独症的危险因素总共有8个,各部分多因素分析显示主要危险因素为:父亲有害职业史、母亲人工流产史、被动吸烟、妊娠浮肿、妊娠呕吐、新生儿黄疸。结论:孤独症不应再被认为是极罕见病,环境因素与孤独症发病有一定关系。     

月经生育因素与乳腺癌关系的Meta分析

[目的]运用Meta分析方法综合分析评价月经生育因素与中国女性乳腺癌的关系。[方法]收集国内有关乳腺癌月经生育因素的病例对照研究文献22篇,采用可信区间方差分析法计算各相关因素的ORc及95%CI。[结果]各研究因素的ORc及95%CI分别为:初潮年龄ORc=0.540(0.450～0.648)、结婚年龄1.376(0.815～2.322)、初产年龄1.558(1.253～1.937)、生育与否0.718(0.320～1.616)、生育胎数0.97(0.705～1.335)、哺乳0.391(0.253～0.605)、哺乳时间0.94(0.884～0.999)、人工流产1.844(1.442～2.358)、绝经与否1.869(1.014～3.444)、绝经年龄1.034(0.706～1.515)、行经期1.223(1.034～1.446)、月经紊乱3.217(2.278～4.542)、月经周期0.446(0.372～0.535)、口服避孕药1.400(0.977～2.006)。[讨论]初潮年龄、哺乳和哺乳时间是乳腺癌的保护因素,初产年龄、人工流产、绝经及行经期是乳腺癌的危险因素,结婚年龄、生育、生育胎数、绝经年龄、月经紊乱、月经周期和口服避孕药与乳腺癌关系尚不明确,有待进一步研究。     

子宫肌瘤发病孕激素相关危险因素病例对照研究

目的研究以孕激素为主的子宫肌瘤发病的危险因素。方法以2014年1月-2015年3月在郑州大学第三附属医院确诊的320例子宫肌瘤患者作为病例组,以同期在该院就诊的320例非子宫肌瘤患者或健康体检者作为对照组,对所有研究对象进行流行病学问卷调查,将结果录入数据库进行单因素和多因素logistic回归分析。结果单因素回归分析显示,既往有孕激素应用史、居住地、体重指数、接触化妆品、食用豆浆和蜂蜜、初潮年龄、经期紊乱、流产次数及服用口服避孕药在病例组与对照组间的差异均有统计学意义(P0.05);多因素回归分析显示,既往应用孕激素、食用豆浆、初潮年龄、经期紊乱、流产次数多与子宫肌瘤发病有关(P0.05)。结论既往有孕激素应用史、食用豆浆、经期紊乱、流产次数多可能是子宫肌瘤发病的危险因素,初潮年龄晚可能是子宫肌瘤发病的保护性因素。     

武汉市妊娠期糖尿病危险因素

目的:探讨妊娠期糖尿病的主要危险因素,为预防妊娠期糖尿病提供理论依据。方法:选取1999年1月～2008年2月在两所附属医院诊断的103例妊娠期糖尿病患者作为病例组,并抽取143例健康孕妇作为对照组,对两组进行单因素、多因素Logistic回归分析。结果:进入多因素非条件Logistic回归模型的因素有本次妊娠年龄、月经初潮年龄、月经周期紊乱病史、自然流产次数、母亲患糖尿病史、父亲患糖尿病史,OR(95%CI)值分别为1.50(1.14～2.04)、0.36(0.16～0.84)、3.85(1.59～9.36)、3.00(1.56～5.77)、3.89(1.15～13.17)、6.54(2.42～17.69)。结论:妊娠年龄、月经周期紊乱病史、自然流产次数、母亲患糖尿病、父亲患糖尿病史为妊娠期糖尿病的危险因素,而月经初潮年龄>14岁为其保护因素。     

Breast cancer in relation to some reproductive factors

Breast cancer is one of the most commonly occurring cancers in females in the Eastern Mediterranean Region. In Egypt women's breast cancer had the highest frequency. The present study was conducted to study the association between breast cancer and some reproductive factors as well as to find out (if possible) predictors for occurrence of breast cancer. A hospital based case control study was carried out in Alexandria Main University Hospital where, 129 histopathologically confirmed incident primary breast cancer cases were included. An equal number of a control group matched by age were selected from the visitors of the same hospital. Data related to women's reproductive period were collected from both cases and controls. The results revealed that there was no statistically significant difference between cases and controls as regards menopausal status, menstruation span, number of births, spontaneous and induced abortion, twin birth, breast feeding and use of oral contraceptives. There was an increasing risk of breast cancer, with the presence of positive family history of breast cancer decreasing age at menarche, increasing age at first full-term pregnancy, widening of the interval between menarche and first full-term pregnancy, increasing age at last full-term pregnancy and shortening of the interval since last birth. Multiple logistic regression analysis revealed that positive family history of breast cancer, young age at menarche, late age at last full-term pregnancy and wide inter-birth interval were significant predictors for occurrence of breast cancer. The results of the study pinpoint that conduction of public health education programmes focusing on the modifiable risk factors are required.     

Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Collaborative Ovarian Cancer Group.

Data collected from 2,197 white ovarian cancer patients and 8,893 white controls in 12 US case-control studies conducted in the period 1956-1986 were used to evaluate the relation of invasive epithelial ovarian cancer to reproductive and menstrual characteristics, exogenous estrogen use, and prior pelvic surgeries. Clear trends of decreasing risk were evident with increasing number of pregnancies (regardless of outcome) and increasing duration of breast feeding and oral contraceptive use. Ovarian dysfunction leading to both infertility and malignancy is an unlikely explanation for these trends for several reasons: 1) The trends were evident even among the highly parous; 2) risk among nulliparous women did not vary by marital status or gravidity; and 3) risk among ever-married women showed little relation to length of longest pregnancy attempt or history of clinically diagnosed infertility. Risk was increased among women who had used fertility drugs and among women with long total duration of premenopausal sexual activity without birth control; these associations were particularly strong among the nulligravid. No consistent trends in risk were seen with age at menarche, age at menopause, or duration of estrogen replacement therapy. A history of tubal ligation or of hysterectomy with ovarian conservation was associated with reduced ovarian cancer risk. These observations suggest that pregnancy, breast feeding, and oral contraceptive use induce biological changes that protect against ovarian malignancy, that, at most, a small fraction of the excess ovarian cancer risk among nulliparous women is due to infertility, and that any increased risk associated with infertility may be due to the use of fertility drugs.     

Role of goiter and of menstrual and reproductive factors in thyroid cancer: a population-based case-control study in New Caledonia (South Pacific), a very high incidence area

Exceptionally high incidence rates of thyroid cancer have been reported for Melanesian women in New Caledonia (South Pacific). To investigate the occurrence of thyroid cancer in that country and to clarify the role of goiter and hormonal factors in that disease in women, a countrywide population-based case-control study was conducted in 1993-1999. The study included 293 cases, identified through pathology registers and whose thyroid cancer was verified histologically, and 354 population controls. Thyroid cancer was associated with goiter, age at menarche, irregular menstruation, and hysterectomy. There was a dose-response trend with number of full-term pregnancies (p = 0.01), with an odds ratio of 2.2 (95% confidence interval: 1.1, 4.3) for women with eight or more pregnancies. Miscarriage, particularly as an outcome of the first pregnancy, was also indicated as a risk factor. The association between voluntary abortion and thyroid microcarcinoma could be explained by enhanced medical surveillance and improved cancer detection in women undergoing abortion. Oral contraceptives and hormone replacement therapy were unrelated to thyroid cancer. The very high birth rate among Melanesian women in New Caledonia, as well as late age at menarche, may explain, in part, their elevated incidence of thyroid cancer.     

妊娠期糖尿病患者发生自发性早产的危险因素和预防措施研究

目的研究影响妊娠期糖尿病(GDM)患者发生自发性早产的危险因素,并通过预测模型研究其预测方案。方法通过随机抽样纳入2016年2月-2019年3月住院治疗的GDM患者,纳入GDM发生自发性早产的患者100例,GDM无自发性早产的患者100例,先对比两组临床基线资料,然后进行单因素及多因素回归分析,计算影响结果的独立危险因素,通过预测模型ROC分析预测价值。结果两组临床基线资料中,妊娠年龄、月经初潮年龄、月经周期紊乱史、自然流产史、糖尿病家族史、孕前体质指数(BMI)、妊娠期感染史等比较,差异均有统计学意义(均P<0.05)。单因素和多因素Logistics回归分析中,月经周期紊乱史、妊娠期感染史两个因素对自发性早产均无影响。妊娠年龄、月经初潮年龄、自然流产史、糖尿病家族史、孕前BMI为影响GDM患者发生自发性早产的独立危险因素。ROC预测模型结果显示,孕前BMI的AUC最高,自然流产史AUC最低为0.645,灵敏度最高为孕前BMI(85%);灵敏度最低为糖尿病家族史(57%);特异度最高为糖尿病家族史(76%),特异度最低为妊娠年龄(46%)。多因素联合做ROC分析可知,AUC=0.873,灵敏度=87%,特异度=73%,95%CI=0.819~0.916。结论妊娠年龄、月经初潮年龄、自然流产史、糖尿病家族史、孕前BMI为影响GDM发生自发性早产的独立危险因素,多因素联合对于预测GDM的发展有着较高的灵敏度及特异度,具有较高的临床价值。     

Relations of gestational length and timing and type of incomplete pregnancy to ovarian cancer risk

While the protective nature of parity with respect to ovarian cancer has been well documented, whether a history of incomplete pregnancy affects ovarian cancer risk is uncertain. Data collected from 739 epithelial ovarian cancer cases and 1,313 community controls in the Delaware Valley from 1994 to 1998 were used to evaluate the relation between gestational length and timing of first induced or spontaneous abortion and ovarian cancer risk. Incomplete pregnancy was not associated with ovarian cancer among nulliparous women or among ever-pregnant women either before or after adjustment for relevant confounders (for nulliparous women, odds ratio (OR) = 1.12, 95% confidence interval (CI): 0.66, 1.89; for ever-pregnant women, OR = 0.95, 95% CI: 0.76, 1.18). Among unigravid women, one full-term pregnancy was more protective than an incomplete pregnancy (adjusted OR = 0.29, 95% CI: 0.15, 0.57). These results were independent of the type of pregnancy loss. Among ever-pregnant women, a spontaneous abortion before a first birth provided significant protection (adjusted OR = 0.47, 95% CI: 0.30, 0.75), while no significant effect was found for an induced abortion prior to a first birth (adjusted OR = 0.80, 95% CI: 0.44, 1.47). These data do not support an independent association between incomplete pregnancies, either spontaneous or induced, and ovarian cancer risk.     

武汉地区女性乳腺癌危险因素的病例对照研究

目的 探讨武汉地区女性乳腺癌的危险因素及其变化情况。方法 以病例对照研究方法,对经病理确诊的213例乳腺癌患者及430例匹配对照进行危险因素的条件logistic回归分析。结果 单因素分析显示:文化程度、乳腺良性肿瘤、初潮年龄、绝经年龄、肉类摄入量、油炸烧烤食物摄入、豆类食品摄入、水果摄入、哺乳时间。体重指数、10～19岁胸透次数、精神心理因素等28项因素与乳腺癌的危险性有关。联合多因素及分组多因素条件1ogistic回归分析显示:文化程度高、精神创伤、乳腺良性肿瘤史、绝经晚、行经年数和初产前行经年数长、体重指数高、常食油炸烧烤和烟熏腊制食物为乳腺癌的危险因素;初潮晚、哺乳时间长、豆类或水果摄入量高、常饮茶为保护因素。绝经前与绝经后的危险因素种类及效应强度有一定差别。经多因素分析,绝经前主要相关因素为乳腺良性肿瘤、初潮年龄、豆类摄入量;绝经后主要与绝经年龄、体重指数、腰臀比和水果摄入量有关。另外,精神创伤及哺乳时间为绝经前后共同的危险因素和保护因素。结论 武汉地区女性乳腺癌危险因素中,饮食习惯和内源性雌激素暴露等相关因素起着重要作用。     

Menstrual factors and the risk of epithelial ovarian cancer

The relationship between menstrual factors and the risk of ovarian cancer was evaluated in the framework of a hospital-based case-control study conducted in the greater Milan area on a total of 634 cases of ovarian cancer and 1626 control subjects with a spectrum of acute conditions unrelated to any of the established or potential risk factors for ovarian cancer. Compared with women whose menarche occurred at age 13 or later, the risk of ovarian cancer was moderately (and not significantly) elevated for earlier menarche (multivariate relative risk, RR = 1.13, 95% confidence interval, CI = 0.97-1.37). There was a positive association with age at menopause, the multivariate relative risk, compared with women aged 45 years or less at menopause, being 1.25 for those aged 45-49 years, 1.40 for 50-53 and 1.58 for 54 or over (chi 2(1) trend = 8.86, p = 0.003). A lifelong irregular menstrual pattern (defined as frequent menstrual-like episodes of bleeding less than 21 or more than 35 days apart) was negatively associated with the risk of ovarian cancer (multivariate RR = 0.45, 95% CI = 0.31-0.65). The effect of age at menopause and lifelong menstrual pattern was similar in different strata of age, whereas there was a positive association with early menarche among younger women which disappeared with advancing age. The present findings confirm the influence of various menstrual factors on the risk of epithelial ovarian cancer.(ABSTRACT TRUNCATED AT 250 WORDS)     

蚌埠市农村已婚妇女乳腺疾病筛查及相关因素调查

目的:探讨蚌埠市农村已婚妇女乳腺疾病的患病率及其影响因素,为有针对性地开展乳腺疾病防治工作提供基础数据。方法:采用分层整群抽样法选取3 089例已婚妇女,采用先集中和后入户的调查方式进行乳腺疾病相关问卷调查。3 089例已婚妇女均接受乳腺检查,内容包括临床体检和乳腺红外线检查。结果:农村已婚妇女乳腺疾病的患病率为13.3%,前3种乳腺疾病分别为乳腺增生、纤维腺瘤和乳腺炎性疾病,其患病率分别为12.9%、0.3%和0.1%。多因素Logistic回归分析显示:相对于初中及以上文化程度妇女,无痛经,无引产、流产史的农村已婚育龄妇女,小学以下文化程度妇女,有痛经,有引产、流产史的妇女罹患乳腺疾病的危险度增高;与年龄≤29岁、月经周期≤24天、月经量少、家庭年均收入≤5 000元的农村已婚育龄妇女相比,年龄大、月经周期时间长、月经量多、家庭年均收入高的妇女罹患乳腺疾病的危险度增加。结论:农村已婚妇女乳腺疾病发生率较高,且受多种因素影响。应坚持定期防癌普查,加强乳腺疾病的二级预防。     

卵巢子宫内膜异位症临床特点及影响因素分析

目的分析卵巢子宫内膜异位症(OEM)的临床特点及影响因素,为临床诊治卵巢子宫内膜异位症提供参考。方法回顾性分析我院2009年5月至2011年9月60例OEM患者的临床资料,总结分析其临床特点;同时收集我院同期60例其它良性附件包块患者的临床资料作为对照组,采用回顾性病例对照研究方法,分析比较OEM的影响因素。结果 60例OEM患者中临床表现为进行性加重痛经43例,月经异常39例,B超发现盆腔肿物26例,CA125检查异常者34例,有盆腔合并症29例。观察组(OEM组)的结婚年龄、生育次数、月经周期、痛经、妇科手术史与对照组(良性附件包块组)相比差异明显,差异具有统计学意义(P<0.05)。结论 OEM的临床表现多为进行性加重痛经、月经异常、盆腔包块,B超及CA125有助于该病的诊断,合并其它盆腔疾病的概率较高。结婚年龄晚、痛经、有妇科手术史可能是OEM发生的危险因素,月经周期长、生育次数多可能是OEM发生的保护因素。