在百万妇女研究中,卵巢癌和激素替代疗法
1Million Women Study Coordinating Centre, Cancer Research UK Epidemiology Unit, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK. pa.valerie.beral@ceu.ox.ac.uk
Lancet (London, England)
|May 22, 2007
概括
使用激素替代疗法 (HRT) 的女性面临患和死于卵巢癌的风险更高. 这项研究发现,自1991年以来,HRT的使用在英国导致了大约1300例卵巢癌和1000例死亡.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 妇科 妇科医生 妇科
背景情况:
- 卵巢癌是英国妇女的重大健康问题,是第四常见的癌症.
- 有限的数据存在于与激素替代疗法 (HRT) 使用相关的卵巢癌的特定风险.
研究的目的:
- 调查激素替代疗法 (HRT) 使用与患卵巢癌和死于卵巢癌的风险之间的联系.
- 量化目前和过去的HRT使用者的卵巢癌风险,与从未使用者相比.
主要方法:
- 一项大规模的队列研究,涉及英国百万妇女研究中的948,576名绝经后妇女.
- 对于发生的卵巢癌,随访时间平均为5.3年,对于死亡率为6.9年,收集和更新了HRT使用数据.
- 计算了相对风险,按年龄和子宫切除状态分层,并根据多种混因素进行调整.
主要成果:
- 与从未使用者相比,当前HRT用户的患卵巢癌 (RR 1.20) 和死于卵巢癌 (RR 1.23) 的风险显著增加.
- 卵巢癌的风险随着HRT使用时间的延长而增加,在不同的瘤组织学中观察到的变化,特别是血清性上皮瘤的风险更高.
- 过去的HRT使用者没有表现出卵巢癌的风险增加 (发病率RR0.98,死亡率RR0.97).
结论:
- 激素替代疗法 (HRT) 的使用与发生性和致命卵巢癌的风险增加有关.
- 该研究估计,自1991年以来,HRT的使用在英国导致了大约1300例额外的卵巢癌病例和1000例额外的死亡.
相关概念视频
Hormonal Control of the Ovarian Cycle
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Menopause
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
Disorders of the Female Reproductive System
The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
Oogenesis
In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
Hormonal Regulation of the Menstrual Cycle
The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.
Hormonal Regulation
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.

