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预防医学  2025, Vol. 37 Issue (5): 516-520    DOI: 10.19485/j.cnki.issn2096-5087.2025.05.018
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初次性行为年龄与妇科恶性肿瘤的孟德尔随机化研究
蒋舒頔1, 郭婷1, 凌军军1, 任婕1, 张亮1,2
1.贵州医科大学附属医院,贵州 贵阳 550004;
2.重庆两江新区中医院,重庆 401123
Association between age at first sexual intercourse and gynecologic malignant tumors: a Mendelian randomization study
JIANG Shudi1, GUO Ting1, LING Junjun1, REN Jie1, ZHANG Liang1,2
1. The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, China;
2. Chongqing Liangjiang New Area Traditional Chinese Medicine Hospital, Chongqing 401123, China
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摘要 目的 采用孟德尔随机化(MR)方法分析初次性行为年龄与妇科恶性肿瘤的因果关系。方法 初次性行为年龄相关单核苷酸多态性(SNP)位点资料来自一项全基因组关联研究(GWAS)的Meta分析,妇科恶性肿瘤(卵巢癌、子宫内膜癌和宫颈癌)及其亚型相关SNP位点资料来自IEU OpenGWAS数据库。以初次性行为年龄为暴露因素,以妇科恶性肿瘤为结局,采用逆方差加权法(IVW)进行MR分析;采用Cochran Q检验评估异质性,采用MR-Egger回归法和MR-PRESSO检验评估工具变量的水平多效性,采用漏斗图检验偏倚。结果 初次性行为年龄越小,卵巢低级别浆液性癌(OR=0.553,95%CI:0.335~0.911)、宫颈癌(OR=0.674,95%CI:0.466~0.974)、子宫内膜癌(OR=0.854,95%CI:0.730~0.999)和子宫内膜样癌(OR=0.830,95%CI:0.690~0.998)发病风险越高。未发现初次性行为年龄与卵巢癌、卵巢高级别浆液性癌、卵巢黏液性癌、卵巢子宫内膜样癌和非子宫内膜样癌的统计学关联(均P>0.05)。敏感性分析未发现工具变量间的异质性和水平多效性(均P>0.05),漏斗图显示不存在偏倚。结论 初次性行为年龄越小可能与部分妇科恶性肿瘤发病风险增加有关,建议加强青少年性教育。
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蒋舒頔
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张亮
关键词 妇科恶性肿瘤初次性行为年龄孟德尔随机化    
AbstractObjective To examine the casual association between age at first sexual intercourse and gynecologic malignant tumors using Mendelian randomization (MR) approach. Methods The single nucleotide polymorphisms (SNPs) associated with age at first sexual intercourse were obtained from a meta-analysis of genome-wide association study (GWAS), and the SNPs related to gynecologic malignant tumors (ovarian cancer, endometrial cancer, cervical cancer), and their subtypes were sourced from the IEU OpenGWAS database. Using age at first sexual intercourse as the exposure and gynecologic malignant tumors as the outcome, a MR analysis was performed with the inverse-variance weighted (IVW) method. Heterogeneity was assessed using Cochran's Q test, horizontal pleiotropy was evaluated using MR-Egger regression and MR-PRESSO test, and bias was examined using funnel plots. Results The Mendelian randomization analysis demonstrated that younger age at first sexual intercourse was significantly associated with an increased risk of low-grade serous ovarian carcinoma (OR=0.553, 95%CI: 0.335-0.911), cervical cancer (OR=0.674, 95%CI: 0.466-0.974), endometrial cancer (OR=0.854, 95%CI: 0.730-0.999), and endometrioid carcinoma (OR=0.830, 95%CI: 0.690-0.998). No statistical association was found between the age at first sexual intercourse and ovarian cancer, high-grade serous ovarian cancer, mucinous ovarian cancer, endometrioid ovarian cancer, or non-endometrioid ovarian cancer (all P>0.05). Sensitivity analysis showed no evidence of undetected instrumental variable heterogeneity or horizontal pleiotropy (all P>0.05), and the funnel plot indicated no presence of bias. Conclusion Younger age at first sexual intercourse may be associated with an increased risk of certain gynecologic malignant tumors, highlighting the need to strengthen adolescent sex education.
Key wordsgynecologic malignant tumor    age at first sexual intercourse    Mendelian randomization
收稿日期: 2024-11-28      修回日期: 2025-04-03     
中图分类号:  R737.3  
基金资助:重庆市中青年医学高端人才项目(渝卫人〔2022〕No.15); 重庆市公共卫生中青年骨干人才项目(渝疾控发〔2024〕19号)
作者简介: 蒋舒頔,硕士研究生在读,主治医师,主要从事妇科肿瘤治疗工作
通信作者: 张亮,E-mail:zhangliangsyd@163.com   
引用本文:   
蒋舒頔, 郭婷, 凌军军, 任婕, 张亮. 初次性行为年龄与妇科恶性肿瘤的孟德尔随机化研究[J]. 预防医学, 2025, 37(5): 516-520.
JIANG Shudi, GUO Ting, LING Junjun, REN Jie, ZHANG Liang. Association between age at first sexual intercourse and gynecologic malignant tumors: a Mendelian randomization study. Preventive Medicine, 2025, 37(5): 516-520.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.05.018      或      http://www.zjyfyxzz.com/CN/Y2025/V37/I5/516
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