家族性卵巢癌高风险女性进行绝经前风险降低输卵管和卵巢切除术对认知的长期影响：横断面研究。
Long-term effects of premenopausal risk-reducing salpingo-oophorectomy on cognition in women with high familial risk of ovarian cancer: A cross-sectional study.
发表日期：2023 Jan 30
作者：
Lara Terra, Philippe R Lee Meeuw Kjoe, Joost A Agelink van Rentergem, Maarten J Beekman, Bernadette A M Heemskerk-Gerritsen, Marc van Beurden, Jeanine E Roeters van Lennep, Helena C van Doorn, Joanna A de Hullu, Marian J E Mourits, Eleonora B L van Dorst, Constantijne H Mom, Brigitte F M Slangen, Katja N Gaarenstroom, Lizet E van der Kolk, J Margriet Collée, Marijke R Wevers, Margreet G E M Ausems, Klaartje van Engelen, Irma van de Beek, Lieke P V Berger, Christi J van Asperen, Encarna B Gomez Garcia, Angela H E M Maas, Maartje J Hooning, Elsken van der Wall, Flora E van Leeuwen, Sanne B Schagen
来源：
Bjog-Int J Obstet Gy
摘要：
为了研究早绝经期风险减少卵巢输卵管切除术（RRSO）对增加卵巢癌风险女性的客观和主观认知影响，研究采用前瞻性随访交叉调查的方式进行，嵌入全国性队列中，为荷兰多中心研究。研究对象为641位女性（66% BRCA1/2致病变异携带者），其中早绝经期RRSO≤45岁的有436人，后绝经期RRSO≥54岁的有205人。所有参与者在招募时年龄都超过55岁。参与者完成了在线认知测试和主观认知问卷。我们使用多元回归分析，校正年龄、教育、乳腺癌、激素替代治疗、心血管危险因素和抑郁症。研究主要关注的是早绝经期RRSO对女性客观和主观认知的影响与后绝经期RRSO进行比较。结果显示，在进行调整后，早绝经期RRSO（RRSO后的平均时间为18.2年）在客观认知测试中与后绝经期RRSO（RRSO后的平均时间为11.9年）表现相似。然而，与后绝经期RRSO相比，她们更频繁地报告出现推理（OR 1.8，95% CI 1.1-3.1）和多任务处理问题（OR 1.9，95% CI 1.1-3.4）。但是，在仅限于60-70岁的年龄相当的妇女的分析中，两组之间的差异消失了。说明安慰的是，在RRSO后约18年后，我们发现早绝经期RRSO与客观认知之间不存在关联。 © 2023 John Wiley＆Sons Ltd.
To examine the effect of a premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer on objective and subjective cognition at least 10 years after RRSO.A cross-sectional study with prospective follow-up, nested in a nationwide cohort.Multicentre in the Netherlands.641 women (66% BRCA1/2 pathogenic variant carriers) who underwent either a premenopausal RRSO ≤ age 45 (n = 436) or a postmenopausal RRSO ≥ age 54 (n = 205). All participants were older than 55 years at recruitment.Participants completed an online cognitive test battery and a questionnaire on subjective cognition. We used multivariable regression analyses, adjusting for age, education, breast cancer, hormone replacement therapy, cardiovascular risk factors and depression.The influence of RRSO on objective and subjective cognition of women with a premenopausal RRSO compared with women with a postmenopausal RRSO.After adjustment, women with a premenopausal RRSO (mean time since RRSO 18.2 years) performed similarly on objective cognitive tests compared with women with a postmenopausal RRSO (mean time since RRSO 11.9 years). However, they more frequently reported problems with reasoning (odds ratio [OR] 1.8, 95% confidence interval [95% CI] 1.1-3.1) and multitasking (OR 1.9, 95% CI 1.1-3.4) than women with a postmenopausal RRSO. This difference between groups disappeared in an analysis restricted to women of comparable ages (60-70 years).Reassuringly, approximately 18 years after RRSO, we found no association between premenopausal RRSO and objective cognition.© 2023 John Wiley & Sons Ltd.