多囊性卵巣症候群と子宮内膜癌
Paul Hardiman1, Ouma C Pillay, William Atiomo
1Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, NW3 2PF, London, UK. hardiman@rfc.ucl.ac.uk <hardiman@rfc.ucl.ac.uk>
Lancet (London, England)
|June 5, 2003
まとめ
多囊性卵巣症候群 (PCOS) と子宮内膜がんの関連性は,リスク要因にもかかわらず不明である. より高いリスクのPCOSを有する女性を特定し,効果的な予防戦略を確立するために,さらなる大規模な研究が必要である.
科学分野:
- 生殖内分泌学 生殖内分泌学
- 婦人科腫瘍学 婦人科腫瘍学
背景:
- 多囊性卵巣症候群 (PCOS) と子宮内膜がんの関連性は,1949年以来議論されてきた.
- 子宮内膜がんの危険因子は,PCOS (アノブレーション,肥満,高インスリン血症) で一般的ですが,発生率または死亡率の増加の直接的な証拠は不確実です.
- 現在の臨床ガイドラインは,リスクを軽減するためにホルモン治療を推奨していますが,最適なプロトコルに関するコンセンサスは欠如しています.
研究 の 目的:
- PCOSと子宮内膜がんを関連付ける証拠を批判的に評価する.
- この関連性を明らかにし,臨床実務に情報を提供するためにさらなる研究が必要であることを強調する.
主な方法:
- 既存の文献と臨床実務ガイドラインのレビュー.
- PCOSに関連する危険因子と子宮内膜がんの発症の関係に関する分析.
主要な成果:
- PCOSと子宮内膜がんの発生率または死亡率の増加との間の直接的な因果関係を支持する証拠は不確実です.
- 共通する危険因子にもかかわらず,PCOSが女性を子宮内膜がんに誘発することを決定的に確立していない.
結論:
- 大規模な疫学研究は,PCOSの女性の子宮内膜がんによる罹病率と死亡率を決定するために不可欠です.
- 高リスクのPCOSを有する女性の特定のサブグループを特定し,標的型リスク軽減戦略を開発することは,重要な将来のステップです.
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