Okamoto M, Okamoto H, Kitahara F, Kobayashi K, Karikome K, Miura K, Matsumoto Y, Fujino M A
Health Care Center, Yamanashi Prefectural Welfare Federation of Agricultural Cooperatives, First Department of Medicine, Yamanashi Medical University, Kofu, Japan.
Am J Gastroenterol. 1999 Feb;94(2):446-50. doi: 10.1111/j.1572-0241.1999.875_d.x.
The purpose of this study was to evaluate the level of gallbladder cancer risk associated with polyps and stones of the gallbladder by ultrasound examinations.
We investigated abdominal ultrasonographic findings for gallstones and polyps of the gallbladder and the relationship of these findings to malignancy in 194,767 asymptomatic participants in health screening examinations.
Gallstones were detected in 7,985 participants (4.1%), at a prevalence of 5.3% in male and 4.5% in female participants. The prevalence was highest in the participants' seventh decade, followed by the sixth and the fifth decades, in both male and female participants. Polyps were found in 10,926 (5.6%), at a prevalence of 6.9% in the male and 4.5% in the female participants. In the male participants, prevalence was highest in the fourth decade, followed by the third and the fifth decades, whereas in the female participants it was highest in the fifth decade, followed by the fourth and third. High prevalence of polyps > or = 10 mm in diameter was found in the fifth to seventh decades in both sexes. Nineteen participants (0.01%) were diagnosed as having gallbladder cancer, and many of them were in the sixth or seventh decade in both sexes. Patients with stones showed a higher prevalence of gallbladder cancer. This difference was shown to be statistically significant by age-adjusted analysis (p < 0.01). The age distribution of the participants with polyps > or = 10 mm in diameter was correlated with that of patients diagnosed with gallbladder cancer. Furthermore, polyp incidence was significantly related to cancer by statistical analysis (p < 0.01).
These results suggest an association between gallstone or polyp of the gallbladder and increased risk of malignancy, implying that an etiological association may also exist.
本研究旨在通过超声检查评估胆囊息肉和结石与胆囊癌风险的关联程度。
我们调查了194767名无症状健康筛查参与者的腹部超声检查结果，包括胆囊结石和息肉情况以及这些发现与恶性肿瘤的关系。
7985名参与者（4.1%）检测出有胆结石，男性患病率为5.3%，女性为4.5%。在男性和女性参与者中，患病率在第七个十年最高，其次是第六和第五个十年。10926名（5.6%）发现有息肉，男性患病率为6.9%，女性为4.5%。在男性参与者中，患病率在第四个十年最高，其次是第三和第五个十年；而在女性参与者中，患病率在第五个十年最高，其次是第四和第三个十年。在第五至第七个十年中，男女直径≥10mm的息肉患病率均较高。19名参与者（0.01%）被诊断患有胆囊癌，其中许多人在男女的第六或第七个十年。有结石的患者胆囊癌患病率更高。经年龄调整分析，这种差异具有统计学意义（p<0.01）。直径≥10mm息肉参与者的年龄分布与被诊断为胆囊癌患者的年龄分布相关。此外，经统计分析，息肉发生率与癌症显著相关（p<0.01）。
这些结果表明胆囊结石或息肉与恶性肿瘤风险增加之间存在关联，这意味着可能也存在病因学关联。
