Association between BRCA mutations and endometrial carcinoma: a systematic review with meta-analysis
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GYNECOLOGIC ONCOLOGY
Association between BRCA mutations and endometrial carcinoma: a systematic review with meta‑analysis Guojiao Lu1 · Tao Lu1 · Jichen Pan1 · Ling Guo1 · Yingxin Pang1 · Peishu Liu1 Received: 18 July 2020 / Accepted: 5 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To first investigate on the association between BRCA mutations and endometrial carcinoma. To first evaluate the contribution of tamoxifen use and risk-reducing bilateral salping-oophenrectomy (BSO) on endometrial carcinoma in BRCA carriers. Methods A systematic search of electronic databases including the PubMed and EMBASE was conducted to identify publications exploring the association between BRCA mutations and endometrial carcinoma. Finally, single rate meta-analysis and diagnostic meta-analysis were performed. Results 11 retrospective studies and 3 prospective studies were included in the meta-analysis, single rate meta-analysis was performed on retrospective studies and prospective studies respectively. We got that incidence of BRCA mutations in patients with endometrial carcinoma is about 0.035, the incidence of endometrial carcinoma in BRCA carriers is about 0.004. Diagnostic meta-analysis performed on prospective studies found that tamoxifen increased incidence of endometrial carcinoma in BRCA carriers. Conclusions The incidence of BRCA mutations in patients with endometrial carcinoma is about 0.035 according to present studies, the incidence of endometrial carcinoma in BRCA carriers is about 0.004. Tamoxifen use is a certain risk factor for subsequent endometrial carcinoma, while history of breast cancer or risk-reducing BSO is not associated with incidence of follow-up endometrial carcinoma. The necessity and rationality of prophylactic hysterectomy for BRCA carriers remained to be discussed. Keywords Endometrial carcinoma · BRCA mutations · Tamoxifen · Prophylactic hysterectomy · BSO · Meta-analysis
Introduction Endometrial carcinoma (EC) is the fourth most frequent cancer in women and most common gynecological malignancy in high-income countries [1]. The general population risk of EC is 2.69% for all races. It affects 63,230 women in the United States in 2018 and will results in 11,350 deaths [2]. It usually occurs in peri or postmenopausal women and Guojiao Lu and Tao Lu contributed equally. * Yingxin Pang [email protected] * Peishu Liu [email protected] 1
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, People’s Republic of China
early symptom is mainly abnormal vaginal bleeding. Highrisk factors for EC consist of unopposed estrogen, obesity, diabetes mellitus, and hypertension [3]. Historically, EC has been classified into two types: Type I and Type II [4]. Type I (endometrioid histology) typically arises from atypical complex hyperplasia, which is estrogen-related with estrogen receptor positivity. Type II (serous, clear cell carcinoma) is not estrogen-related and it is thought to be associated with its prec
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