山东省上皮性卵巢癌发病因素分析——病例配对研究

背景与目的：卵巢癌在妇科恶性肿瘤中列第二位,其死亡率列第一位,尽管研究发现某些因素与卵巢癌发病有关系,但卵巢癌发病病因尚未定论,本课题的El的是研究卵巢癌发病的危险因素,探讨卵巢癌的发病原因。方法：将山东省19所地市以上综合医院住院经病理确诊的307例上皮性卵巢癌患者做为病例组．同时将同期住院的非恶性肿瘤患者307例1：1配对作为对照组,调查105个因素．资料用条件logistic回归单因素和多因素分析方法进行统计学处理。结果：单因素分析结果筛选出25个因素：接受过学校教育、经济状况好、排卵年延长、长时间放置官内节育器（intrauterine device,IUD）、多食肉类、甜食、脂肪、大便不规律、便秘、接触有害物质、精神抑郁、焦虑、精神紧张、性格急噪、精神创伤、一级亲属卵巢癌家族史阳性是卵巢癌发病危险因素。然而,未接受过学校教育、月经周期延长、婚后至首次妊娠间隔时间长、孕次增加、哺乳时间延长、产后停经时间延长、子宫或／和一侧卵巢切除、多食蔬菜水果、性格温和是降低卵巢癌发病危险的因素。多因素logistic回归分析显示月经周期延长、孕次多、多食蔬菜水果、和性格温和是保护因素．而使用IUD时间长、多食肉类和精神创伤是卵巢癌发病的危险因素。结论：卵巢癌的发病并非由单一因素所致,而是多因素参与卵巢癌的发生发展过程。     

轮班工作与卵巢癌关系的研究进展

卵巢癌发病率居女性恶性肿瘤第三位,死亡率居首位,且预后较差,对女性生命健康造成严重威胁,其发病及预后与遗传、内分泌失调以及不良生活方式等因素有关.近年来,有学者开展了生活方式,特别是轮班工作与卵巢癌发生及发展关系的研究.轮班工作会导致昼夜节律紊乱,影响体内的激素平衡,可能是卵巢癌的危险因素.本综述归纳了轮班工作与卵巢癌...     

125例上皮性卵巢癌的预后分析

目的探讨上皮性卵巢癌的预后影响因素。方法回顾性分析2005年1月至2007年12月在江苏省肿瘤医院初诊的125例卵巢癌患者的临床资料，通过电话随访及患者返院复查的方式对患者病情变化进行追踪，随访统计截止日为2012年12月31日，分析患者年龄、肿瘤临床分期、病理类型、分化程度、术前辅助化疗、后残余肿瘤直径、化疗的总疗程数与预后的关系。结果患者年龄、肿瘤临床分期、术后残余肿瘤直径与患者的预后密切相关（P〈0．05），病理类型、分化程度、化疗的总疗程数对预后无明显影响（P〉0．05）。结论卵巢癌患者的发病年龄、卵巢癌的临床分期、术后残留肿瘤的大小均可影响卵巢癌的预后，是卵巢癌的独立预后因素。所以，早期发现和诊断、彻底的手术治疗是改善其预后的根本。     

黏蛋白表达与卵巢癌诊治及预后的关系简

黏蛋白是一种高分子量糖蛋白，主要表达在呼吸道、胃肠道和生殖道器官的上皮细胞表面。黏蛋白在肿瘤细胞中异常表达，与肿瘤的进展和浸润密切相关。目前黏蛋白在卵巢癌中的表达已被广泛研究，本文主要总结了卵巢癌的发病机制及黏蛋白在卵巢癌早期诊断、预后判断和治疗方面的应用。     

子宫内膜异位症相关性卵巢癌的研究进展

子宫内膜异位症（EM）作为妇科常见的良性疾病之一,可对育龄期女性的身心健康和生命质量产生严重的影响。研究表明,EM患者患卵巢癌的风险较普通人群明显升高,EM与部分卵巢癌的发生有着密切的关系,并将这类卵巢癌命名为子宫内膜异位症相关性卵巢癌（EAOC）。文章就EAOC的发病率、发病机制、治疗及预后等相关问题进行综述,以期更...     

同时性卵巢癌合并非小细胞肺癌1例并文献复习

目的:探讨多原发癌的临床诊断、治疗和预后,提高对多原发癌的认识,从而延长患者生存期,改善预后。方法:报道1例卵巢癌同期并非小细胞肺癌的多原发癌病例,并通过文献复习,阐述其发病率、发病机制、临床诊治方法及预后。结果:1名54岁女性以卵巢癌收住入院,行胸部CT及病理穿刺活检诊断同时合并肺腺癌,遂采用紫杉醇联合卡铂3周方案化疗,并肺部病灶射频消融。6周期化疗后,持续口服埃克替尼靶向治疗近13个月,肺部病灶较前明显缩小,卵巢癌无复发及转移征象。结论:临床需提高多原发癌的诊断意识,掌握多原发癌发病特点、诊疗方法,以提高治疗水平。     

卵巢癌发病率与动物性食物的相关关系及死亡队列研究

目的通过研究卵巢癌发病率与有关食物的相关关系,为肿瘤的预防提供线索.方法用日本山梨医科大学第一卫生保健教研室提供的肿瘤发病数据库(IARC,1988～1992)和食物供应数据库(FAO,1961～1990),对世界42个国家(地区)卵巢癌的发病率与有关食物的消费量进行了相关分析;出生死亡队列研究的年龄别死亡人数及人口数,来自“日本死亡统计数据库”,由日本文部省提供.结果在所分析的36种食物中,动物性食物消费量与45岁以上卵巢癌年龄标化发病率关系最密切,其中动物性油脂(r=0.412)、鸡蛋(r=0.503)和肉类(r=0.456)的相关系数较大.逐步多元回归发现,不同时期不同食物的消费量,对卵巢癌发病率的影响不同,1961～1965年期间,肥肉消费量影响较大,复相关系数R为0.412 =0.015)1961～1970年,鸡蛋的影响较大,R=0.439 =0.015)1961～1990年间,肉类食物的影响较大,R=0.456(P=0.003).死亡队列研究发现,出生越晚,死亡率越高,其中1945年前后出生的人群死亡率最高.结论在动物性食物中,油脂、鸡蛋和肉类的摄入量与卵巢癌发病率关系较密切,未发现黄油和脂肪与发病率有统计学意义的相关关系.     

DNA甲基化与卵巢癌多药耐药及预后的关系

目的:卵巢癌是严重威胁女性健康的疾病,病死率居妇科恶性肿瘤之首。多药耐药是卵巢癌患者术后化疗失败的主要原因,而DNA甲基化则是卵巢癌多药耐药调控的重要机制,因此全面了解DNA甲基化对卵巢癌多药耐药的调控机制对于卵巢癌治疗和预后具有重要意义。通过Pub Med数据库检索,笔者共提取了26个与卵巢癌多药耐药调控显著相关的DNA甲基化基因,系统整合分析了这些基因甲基化水平改变对卵巢癌耐药的影响及其分子调控机制。在所有26个基因中,至少一半以上的DNA甲基化基因直接或间接地通过调控细胞凋亡信号通路响应耐药调控,说明该信号通路可能是DNA甲基化基因行使其耐药生物学功能的主要方式。另外,分析这26个卵巢癌耐药相关甲基化基因与患者临床预后的关系,表明上述基因主要与不良预后相关。总之,深入探讨DNA甲基化基因与卵巢癌耐药和预后的潜在关系,对于充分认识DNA甲基化对卵巢癌耐药的调控及提高卵巢癌的疗效和改善预后具有一定的指导意义。     

妇科肿瘤基础研究的一些进展

抓年代癌基因与抑癌基因的发现，推动了整个肿瘤分子生物学的飞速发展。目前，已知绝大多数人类恶性肿瘤的发生与发展均与癌基因及抑癌基因相关。人类各种恶性肿瘤有其共性也有其个性。从癌基因与抑癌基因水平研究妇科肿瘤的发病机理，寻找其发生发展的内在规律，可为估计预后提供新指标，为选择治疗方案提供依据，并为基因治疗提供线索。卵巢癌卵巢癌有关研究最为活跃，发现许多癌基因与抑癌基因与之相关。1。基因ras基因家族包括H－。。K一N一及R一础四个成员，均编码分子量为对gn的蛋白质，即pZI。K一与卵巢癌的关系密切，其突变率为…     

非编码RNA在肿瘤微环境中促进卵巢癌发生发展的研究进展

卵巢癌是严重威胁女性生命健康的恶性肿瘤,治疗效果不佳,预后差。卵巢癌的发病是一个复杂过程,具有多因素、多层次的特点,是目前的研究热点。卵巢癌中各种失调的非编码RNA(ncRNA)可在其独特的肿瘤微环境中调控卵巢癌的发生发展,与卵巢癌的发病机制密切相关。ncRNA如长链非编码RNA(lncRNA)、微小RNA(miRNA)、环状RNA等通过调控靶基因的表达及下游通路,参与卵巢癌细胞的多种生命活动,影响其增殖、凋亡、侵袭转移及耐药过程等,促进卵巢癌的发生发展。本文总结了近年来ncRNA在肿瘤微环境中促进卵巢癌发生发展的研究进展,期望为卵巢癌的诊治寻找新靶点,提供新思路和理论依据。     

外泌体及其携带的非编码RNA在卵巢癌诊疗中的研究进展

卵巢癌为3大妇科恶性肿瘤之一,其发病率逐年上升,病死率位居妇科肿瘤首位,由于其早期诊断率低、复发率高和易产生化疗耐药,卵巢癌临床治疗效果较局限,预后较差.研究发现,外泌体(exosomes)携带有细胞来源的DNA、RNA和蛋白质等物质,可参与调节肿瘤细胞与肿瘤微环境之间的细胞间通讯,其携带的非编码RNA在转录、转录后及...     

Dietary and Other Risk Factors of Ovarian Cancer among Elderly Women

The age-specific mortality rate of ovarian cancer is increasing among women over 50 years of age, but remaining at a stable level among women under 50. This case-control study of ovarian cancer was undertaken to assess the environmental factors which may increase the mortality of the disease in the elderly. Fifty-six women with primary epithelial ovarian cancer whose ages were 50 years old or over were compared with two age-matched control groups. The results of the Mantel-Haenszel analysis were as follows. More cases were found to have never married than controls ( P <0.05), a larger proportion of cases were nulliparous ( P <0.05), a smaller proportion of cases had experienced an induced abortion ( P < 0.05) or had undergone permanent sterilization by tubal ligation ( P <0.05), the occurrence of breast or uterine cancer was more common in the mother or sisters of cases ( P <0.01), a larger percentage of cases used to eat meat daily ( P < 0.01) or used to eat fish daily ( P < 0.05), and a larger proportion of cases weighed under 40 kg ( P <0.05). Daily meat consumption was significantly associated with the occurrence of ovarian cancer even after adjusting for reproductive and other risk factors by conditional logistic regression analysis. The attributable risk for ovarian cancer in the elderly was 19.2% for daily meat consumption. The recent change in dietary habits might in part explain the rise of the mortality rate among the Japanese elderly.     

Dietary and other risk factors of ovarian cancer among elderly women

The age-specific mortality rate of ovarian cancer is increasing among women over 50 years of age, but remaining at a stable level among women under 50. This case-control study of ovarian cancer was undertaken to assess the environmental factors which may increase the mortality of the disease in the elderly. Fifty-six women with primary epithelial ovarian cancer whose ages were 50 years old or over were compared with two age-matched control groups. The results of the Mantel-Haenszel analysis were as follows. More cases were found to have never married than controls (P less than 0.05), a larger proportion of cases were nulliparous (P less than 0.05), a smaller proportion of cases had experienced an induced abortion (P less than 0.05) or had undergone permanent sterilization by tubal ligation (P less than 0.05), the occurrence of breast or uterine cancer was more common in the mother or sisters of cases (P less than 0.01), a larger percentage of cases used to eat meat daily (P less than 0.01) or used to eat fish daily (P less than 0.05), and a larger proportion of cases weighed under 40 kg (P less than 0.05). Daily meat consumption was significantly associated with the occurrence of ovarian cancer even after adjusting for reproductive and other risk factors by conditional logistic regression analysis. The attributable risk for ovarian cancer in the elderly was 19.2% for daily meat consumption. The recent change in dietary habits might in part explain the rise of the mortality rate among the Japanese elderly.     

凋亡抑制蛋白与卵巢癌化疗耐药

卵巢癌是严重威胁妇女健康的恶性肿瘤之一,其病死率在妇科肿瘤中占第一位.化疗耐药是导致其治疗失败、病死率居高不下的重要原因.已有的研究表明,抗凋亡机制在肿瘤细胞发生、发展及化疗耐药中起重要作用.凋亡抑制蛋白(IAPs)是重要的细胞凋亡调节因子,在细胞凋亡中起关键作用.本文主要综述IAPs与卵巢癌化疗耐药的相关进展.     

Risk factors for ovarian cancer histotypes

To analyse the risk factors for different histologic types of ovarian cancer, we conducted a case-control study. The cases included 750 women with incident, histologically confirmed invasive epithelial ovarian cancer subdivided into: 493 serous, 81 mucinous, 78 endometrioid, and 98 other histologies. The controls included 2411 women admitted to the same hospitals as cases. The odds ratios for women with three or more births, in comparison with nulliparae, were 0.6 for serous, 0.4 for endometrioid, 1.0 for mucinous and 0.7 for other histological types of ovarian cancer. Family history of ovarian/breast cancer was associated to the risk of all ovarian cancer types, except mucinous ones. Selected dietary factors were less strongly directly (meat and starch), or inversely (fish and vitamin E) related to mucinous than to other histological types of ovarian cancer. High occupational physical activity was inversely related to the risk of ovarian cancer, with no heterogeneity across histologies. In conclusion, the association of reproductive factors and of selected dietary habits was weaker for mucinous ovarian cancer than for other histologic types.     

Clinicopathological comparisons of familial and sporadic cases in 219 consecutive Japanese epithelial ovarian cancer patients

BACKGROUND: It is estimated that approximately 5-10% of epithelial ovarian cancer patients in Western countries are associated with an autosomal dominant inheritance with variable penetrance. There are a few reports of familial ovarian cancer in Japan and considerable uncertainties remain regarding Japanese familial ovarian cancer. The aim of this study was to clarify the clinicopathological features of Japanese familial ovarian cancer. METHODS: We studied clinicopathological findings for 219 consecutive epithelial ovarian cancer patients treated at our institution from April 1987 to September 1997. RESULTS: Eleven patients in nine families were diagnosed as familial ovarian cancer and the incidence of familial cases was 5.0%. Most women (90.9%) with familial cases were diagnosed as the breast ovarian cancer syndrome, whereas ovarian cancer associated with hereditary nonpolyposis colorectal cancer was relatively rare (9.1%). Serous adenocarcinoma, high histological grade, advanced FIGO stage and breast cancer as multiple primary cancer were significantly more common in familial cases compared with sporadic cases (p < 0.001, p < 0.05, p < 0.005 and p < 0.005, respectively). Earlier age of onset was thought to be a characteristic of familial ovarian cancer in Western countries; however, we did not find any difference in age at diagnosis between familial and sporadic cases (53.4 vs 51.3 years). The prognosis of familial ovarian cancer remains controversial and our data did not show a significant difference (p = 0.45) in prognosis between these two groups. CONCLUSION: These findings, except for age at diagnosis, in Japanese familial ovarian cancer are in accordance with the features of familial ovarian cancer in Western countries.     

二次肿瘤细胞减灭术治疗复发性卵巢癌的研究进展

二次肿瘤细胞减灭术（secondary cytoreductive surgery,SCS）作为复发性卵巢癌的治疗方法之一,以完全切除肿瘤,使残留病灶达到最小为目标,主要适用于铂敏感性复发性上皮性卵巢癌(epithelial ovarian cancer,EOC)的治疗。这种再次手术切除肿瘤病灶的方式与传统治疗方式相比,能否改善复发性卵巢癌患者生存和预后,给患者带来新的希望,目前没有确切结论。术前准确预测SCS的效果,选择更适合进行SCS的复发性卵巢癌患者,分析影响SCS预后的因素,可以使SCS更好地应用于复发性卵巢癌的治疗。本文对SCS治疗复发性卵巢癌的适应证、手术方法以及预后影响因素进行综述。     

卵巢癌血清相关miRNAs的筛选及其临床意义

背景与目的：卵巢癌预后较差,发现时通常是晚期,需找寻与卵巢癌发生、发展相关的诊治方法。该研究检测miRNA在上皮性卵巢癌患者术前外周血清及良性卵巢肿瘤患者外周血清中表达情况的差异,筛选差异有统计学意义的miRNA并分析其与上皮性卵巢癌患者临床病理特征、预后等的关系。方法：定制研究相关的48种miRNA表达谱芯片,通过TaqMan低密度微阵列芯片,筛选出有统计学意义的miRNA。采用实时荧光定量聚合酶链反应(real-time fluorescent quantitative polymerase chain reaction,RTFQ-PCR)法验证筛选的miRNA在卵巢良、恶性肿瘤患者血清中的表达情况,选择具有统计学意义的miRNA行大样本验证并分析其与肿瘤分期、组织病理及预后等的关系。结果：通过TaqMan低密度微阵列芯片筛选和RTFQ-PCR验证,发现miR-125b在上皮性卵巢癌患者血清中的表达高于良性肿瘤患者(P=0.039),miR-125b在早期患者中的表达量高于晚期患者(P=0.003),术后无残余肿瘤患者表达量高于术后有残余肿瘤患者(P=0.013)。血清miR-125b高表达有利于卵巢癌患者无进展生存期(progression-free survival,PFS)延长(P=0.003),但对总生存期(overall survival,OS)无明显影响(P=0.069)。结论：miR-125b在上皮性卵巢癌的发生、发展中起着关键作用,与患者预后相关,是预测卵巢癌复发的潜在基因,但在肿瘤不同期别的表达情况发生变化,在早期作用比较明显,在晚期或肿瘤残余较多的患者表达较不明显,其作用机制有待进一步研究。     

Red and processed meat consumption and risk of ovarian cancer: a dose-response meta-analysis of prospective studies

Background:

During the last decade, the epidemiological evidence on consumption of meat and risk of ovarian cancer has accumulated.

Methods:

We assessed the relationship between red and processed meat consumption and risk of ovarian cancer with a dose-response meta-analysis. Relevant prospective cohort studies were identified by searching the PubMed and EMBASE databases through 21 January 2011, and by reviewing the reference lists of retrieved articles. Study-specific relative risk (RR) estimates were combined using a random-effects model.

Results:

Eight cohort studies were included in the meta-analysis. The summary RR for an intake increment of 100 g per week was 1.02 (95% confidence interval (CI), 0.99–1.04) for red meat and 1.05 (95% CI, 0.98–1.14) for processed meat. For an intake increment of four servings per week, the summary RR of ovarian cancer was 1.07 (95% CI, 0.97–1.19) for red meat (100 g per serving) and 1.07 (95% CI, 0.97–1.17) for processed meat (30 g per serving).

Conclusion:

Results from this dose-response meta-analysis suggest that red and processed meat consumption is not associated with risk of ovarian cancer. Although a lower consumption of red and processed meat may offer protection against other types of cancer, other interventions are needed to reduce the risk of ovarian cancer.