Pelvic Inflammatory Disease And Risk Of Ovarian Tumor:a Mata Analysis

Abstract:Objective To meta analysis literature regarding the relationship between Pelvic Inflammatory Disease (PID) and the risk of ovarian tumor. Methods We searched PubMed, EMbase, The Cochrane Library, CBM, CNKI and WANFANG(from inception to Oct,2013). Cohort or case—control studies were identified according to the inclusion and exclusion criteria. Then the quality of the included studies was assessed, and the data was extracted. Meta—analysis was performed by RevMan5.2software. The incorporated OR(odds ratio) and95%CI(confidence interval) of the included cohort studies and incorporated OR and95%CI of case—control studies were calculated, respectively. Results two cohort studies and eight case—control studies were included. Result of meta—analysis on cohort studies showed PID can increase the risk of ovarian tumor(OR=1.72,95%CI1.17to2.52, P=0.006). Besides, result of meta—analysis on case—control studies showed PID was not associated with the incidence of ovarian tumor (OR=1.07,95%C10.86to1.33, P=0.55).However, two studies found that recurrent PID increased risk of ovarian cancer. Risch’s research suggests that after adjustment for confounding factors, when PID exposed to≥2times,the risk of ovarian tumor was1.88times than no history of PID (OR1.88,95%CI1.13to3.12, P=0.0065). After adjusting for age, comorbidities (including endometriosis), Lin’s study showed when the PID exposed to more than5times, the risk of ovarian cancer increased (HR2.46,95%CI1.48to4.09). Conclusion Result of meta—analysis on cohort studies showed PID exposured can increase the risk of ovarian tumor, result of meta—analysis on case—control studies showed PID was not associated with the incidence of ovarian tumor.Hower,PID exposure more than2times was associated with increase in risk of ovarian tumor.Because of the limited quantity of case—control studies and too few cohort studies, there is a need to develop more high-quality prospective study to further validate these results, especially the risk relationship between recurrent or chronic PID and ovarian tumor.