News Express: UM and international researchers discover that unilateral salpingo-oophorectomy reduces ovarian cancer risk
新聞快訊：澳大聯合國際團隊發現切除單側輸卵管卵巢減患卵巢癌風險
單側輸卵管卵巢切除術後卵巢癌、心血管疾病、骨質疏鬆的風險
The association of unilateral salpingo-oophorectomy with ovarian cancer, coronary artery disease, and osteoporosis
澳大聯合國際團隊發現切除單側輸卵管卵巢減患卵巢癌風險
由澳門大學健康科學學院教授紀建光、福建醫科大學婦兒臨床醫學院副教授衣歡、瑞典隆德大學教授Jan Sundquist及Kristina Sundquist共同領導的國際研究團隊發現，機會性單側輸卵管卵巢切除術可顯著降低患上高級別漿液性卵巢癌的風險，且不會增加長期併發症風險，可作為雙側輸卵管卵巢切除或預防性雙側輸卵管切除的替代手術方案。該突破性研究成果已發表於綜合性權威期刊《PLOS Medicine》。
儘管早診早篩的理念在廣泛普及，但由於缺乏早期的篩查手段，70%的卵巢癌診斷時是臨床晚期，且發病率居高不下。臨床指南推薦雙側輸卵管卵巢切除術作為高危卵巢癌風險人群的手術方式，然而，研究報道雙側輸卵管卵巢切除術在絕經前女性中的應用會導致雌激素、孕酮和雄激素水平的急劇下降，這可能引發早發性更年期症狀，並對冠狀動脈疾病和骨骼健康產生不利影響。
該項基於瑞典全國臨床登記數據的大規模研究，首次利用1993至2018年的全國性資料，證實年齡低於50歲的絕經前女性在接受機會性單側輸卵管卵巢切除術後，於長期隨訪中，其患上高級別漿液性卵巢癌的風險下降了36%，且保留了內分泌功能。研究亦顯示，長期追蹤結果證實，該手術亦不增加冠心病和骨質疏鬆的風險。該突破性證據表明，機會性單側輸卵管卵巢切除術可作為雙側輸卵管卵巢切除或預防性雙側輸卵管切除的替代手術方案，以降低卵巢癌的風險，為臨床中具有卵巢癌高風險的絕經前女性提供了保留內分泌功能的手術選擇。
該研究針對絕經前女性患癌風險和內分泌功能保留的矛盾點為契機，表明單側輸卵管卵巢手術在降低卵巢癌風險中的重要作用，同時，規避了傳統雙側輸卵管卵巢切除術對心腦血管和骨骼健康的損害，是平衡癌症預防與長期生活質量的優化方案，為制定卵巢癌高危人群診治指南提供了高等級的證據支持。
該研究通訊作者為紀建光，第一作者為衣歡。該研究獲福建醫科大學婦幼健康醫院科研基金（檔案編號：2021Y9180）及澳門大學（檔案編號：UMDF-TISF/2025/001/FHS）支持。全文可瀏覽：https://pmc.ncbi.nlm.nih.gov/articles/PMC12233271/。
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https://www.um.edu.mo/zh-hant/news-and-press-releases/press-release/detail/61762/
UM and international researchers discover that unilateral salpingo-oophorectomy reduces ovarian cancer risk
An international research team jointly led by Ji Jianguang, professor in the Faculty of Health Sciences (FHS) at the University of Macau (UM), Yi Huan, associate professor at Fujian Maternity and Child Health Hospital of Fujian Medical University, and Jan Sundquist and Kristina Sundquist, professors at Lund University in Sweden, has discovered that opportunistic unilateral salpingo-oophorectomy (USO) can significantly reduce the risk of developing high-grade serous ovarian cancer (HGSOC) without increasing the risk of long-term complications. USO can serve as an alternative to bilateral salpingo-oophorectomy (BSO) or prophylactic bilateral salpingectomy. This groundbreaking research has been published in the prestigious journal PLOS Medicine.
Despite growing awareness of the importance of early diagnosis and screening, approximately 70% of ovarian cancer cases are diagnosed at an advanced stage due to the lack of effective screening methods at an early stage, and the incidence rate remains high. Current clinical guidelines recommend BSO as a surgical option for individuals at high risk of ovarian cancer. However, studies have reported that BSO in premenopausal women can lead to an abrupt decline in oestrogen, progesterone, and androgen levels. This can potentially trigger premature menopause symptoms, as well as having adverse effects on coronary artery disease (CAD) and bone health.
This large-scale registry-based study used nationwide clinical data from Sweden between 1993 and 2018. It revealed that premenopausal women under the age of 50 who underwent opportunistic USO experienced a 36% reduction in the risk of developing HGSOC during long-term follow-up while preserving endocrine function. The long-term follow-up results also confirmed that the surgery did not increase the risk of CAD or osteoporosis. This breakthrough evidence establishes opportunistic USO as a viable alternative to BSO or prophylactic bilateral salpingectomy for reducing the risk of ovarian cancer. It offers premenopausal women at high risk of ovarian cancer a surgical option that preserves endocrine function.
This study addresses the critical trade-off between reducing cancer risk and preserving endocrine function in premenopausal women, highlighting the significant role of USO in reducing ovarian cancer risk. Unlike traditional BSO, USO avoids the damage to cardiovascular and bone health, offering an optimised solution that balances cancer prevention with long-term quality of life. The study also provides robust evidence to inform the development of clinical guidelines for high-risk ovarian cancer populations.
The corresponding author of this study is Ji Jianguang, and the first author is Yi Huan. The research was funded by the Fujian Medical University Fund for Women and Children’s Hospital (File No.: 2021Y9180), and the University of Macau (File No.: UMDF-TISF/2025/001/FHS). The full version of the research article is available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12233271/.
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https://www.um.edu.mo/news-and-press-releases/press-release/detail/61762/