内源性性激素与子宫内膜癌风险的关系：一项系统综述和荟萃分析

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-04-22 DOI:10.1016/j.ejogrb.2025.113997

Pengfei Zhu , Juanjuan Ren , Jing Sun , Jingjing Geng, Huan Wang, Mingming Ma

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引用次数: 0

摘要

目的内源性性激素在子宫内膜癌（EC）风险中的作用在研究中仍然存在矛盾。本荟萃分析旨在探讨循环性激素浓度和性激素结合球蛋白（SHBG）与EC风险的关系。方法检索PubMed、Web of Science和Scopus数据库，纳入相关研究。使用随机效应模型，我们使用95%置信区间（CI）的比值比（OR）来汇集效应大小。结果该分析包括16项研究，292,695名参与者。SHBG水平与EC呈负相关（OR: 0.67）。相反，高循环水平的总睾酮（OR: 1.70）、游离睾酮（OR: 1.75）、硫酸脱氢表雄酮（OR: 1.39）和雄烯二酮（OR: 1.58）与EC风险呈正相关。雌激素也显示出显著的相关性，因此雌酮（OR: 1.55）、未结合的雌酮（OR: 1.86）、雌二醇（OR: 1.38）、未结合的雌二醇（OR: 2.14）、雌三醇（OR: 1.75）和未结合的雌三醇（OR: 1.99）与EC风险增加有关，而结合的雌激素没有显示出显著的相关性。SHBG、雌酮、雌二醇和总睾酮呈非线性剂量-反应关系。结果受年龄、癌症类型、地理区域、绝经状态、研究类型和协变量调整水平的显著影响。对于所有的激素，只有绝经后的妇女才发现有显著的关联。结论：本研究发现SHBG和EC之间呈负相关，而性激素（结合雌激素除外）与EC风险之间存在直接关系，仅在绝经后妇女中存在。

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The association of endogenous sex hormones with endometrial cancer risk: A systematic review and meta-analysis

Objectives

The role of endogenous sex hormones in the risk of endometrial cancer (EC) remains contradictory across the studies. This meta-analysis was carried out to investigate the relation of circulating concentrations of sex hormones and sex hormone-binding globulin (SHBG) to EC risk.

Methods

A search of the PubMed, Web of Science, and Scopus databases was conducted to include relevant studies. We used odds ratios (OR) with 95% confidence intervals (CI) to pool effect sizes using a random effects model.

Results

The analysis included 16 studies with 292,695 participants. SHBG levels showed an inverse relationship with EC (OR: 0.67). In contrast, higher circulating levels of total testosterone (OR: 1.70), free testosterone (OR: 1.75), dehydroepiandrosterone sulfate (OR: 1.39), and androstenedione (OR: 1.58) were positively associated with EC risk. Estrogens also demonstrated significant associations, so that estrone (OR: 1.55), unconjugated estrone (OR: 1.86), estradiol (OR: 1.38), unconjugated estradiol (OR: 2.14), estriol (OR: 1.75), and unconjugated estriol (OR: 1.99) were linked to increased EC risk, while conjugated estrogens showed no significant associations. A non-linear dose–response relationship was found for SHBG, estrone, estradiol, and total testosterone. The results were significantly affected by age, cancer type, geographic region, menopausal status, study type, and the level of adjustments for covariates. For all hormones, the significant associations were found only for postmenopausal women.

Conclusions

This study found an inverse association between SHBG and EC, while identified a direct relationship between sex hormones, except for conjugated estrogens, and EC risk only in postmenopausal women.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.