预防性输卵管-卵巢切除术对BRCA1和BRCA2突变携带者预防卵巢癌作用的系统评价

发布时间：2019-07-09 18:52

【摘要】：目的系统评价预防性输卵管-卵巢切除术(risk-reducing salpingo oophorectomy,RRSO)对BRCA1和BRCA2(以下简称BRCA1/2)突变携带者预防卵巢癌发生的作用,从而为临床医生、遗传咨询师和BRCA1/2突变携带女性提供参考依据。方法 2017年3月至2017年4月检索国内外文献数据库,收集RRSO对BRCA1/2突变携带者发生卵巢癌影响的相关研究。共纳入5项研究,9973例(其中行RRSO组5227例,随访组4746例),运用Revman5.3进行Meta分析。结果 RRSO明显降低了BRCA1/2突变携带者发生卵巢癌的风险(HR=0.19,95%CI:0.14~0.26,P0.00001)。同时,RRSO还降低了BRCA1/2突变携带者的全因病死率(HR=0.32,95%CI:0.27~0.38,P0.00001)。结论对于携带BRCA1/2突变的女性,在完成生育后,应进行遗传咨询,结合患者意愿及其年龄,考虑是否行RRSO,以降低卵巢癌发病率和全因病死率。
文内图片：

图片说明：RRSO组和随访组卵巢癌发生风险比较的Meta分析
[Abstract]:Objective to systematically evaluate the effect of preventive fallopian tube ovariectomy (risk-reducing salpingo oophorectomy,RRSO) on the prevention of ovarian cancer in BRCA1 and BRCA2 (BRCA1/2) carriers, so as to provide reference for clinicians, genetic counsellors and women with BRCA1/2 mutation. Methods from March 2017 to April 2017, the literature databases at home and abroad were searched, and the effects of RRSO on ovarian cancer in BRCA1/2 carriers were collected. A total of 9973 cases (5227 cases in RRSO group and 4746 cases in follow-up group) were included in 5 studies. Meta analysis was performed with Revman5.3. Results RRSO significantly reduced the risk of ovarian cancer (HR=0.19,95%CI:0.14~0.26,P0.00001) in carriers with BRCA1/2 mutation. At the same time, RRSO also reduced the all-cause mortality (HR=0.32,95%CI:0.27~0.38,P0.00001) of BRCA1/2 mutation carriers. Conclusion for women with BRCA1/2 mutation, genetic counseling should be carried out after birth, and whether RRSO, should be performed to reduce the incidence and all-cause mortality of ovarian cancer should be considered according to the wishes of the patients and their age.
【作者单位】：安徽医科大学附属省立医院妇产科;安徽省肿瘤医院妇瘤科;安徽医科大学流行病与统计学系;
【分类号】：R737.31

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