Lowenfels A B, Maisonneuve P, Boyle P, Zatonski W A
Department of Surgery, New York Medical College, Valhalla, New York 10595, USA.
Hepatogastroenterology. 1999 May-Jun;46(27):1529-32.
Gallbladder cancer, although rare in most Caucasian populations, is among the most frequently observed cancers in native populations of North and South America, and in the Maori population of New Zealand. In all populations, there is a strong correlation between gallstones and gallbladder cancer: the risk of gallbladder cancer is approximately 4-5 times higher in patients with gallstones, than in patients without gallstones. In those populations where the onset of gallstone disease occurs in the first few decades, the risk is much higher. Obesity, which is also a risk factor for gallstones, increases the risk of gallbladder cancer, as does the consumption of diets high in fats and calories. Other risk factors, such as increased parity, also increase the frequency of gallbladder cancer, most probably explained by the association between gallstones and parity. Prophylactic cholecystectomy for asymptomatic gallstones cannot be justified for the control of gallbladder cancer, but the increasing frequency of this procedure in many countries, secondary to the widespread use of laparoscopic surgical techniques, will clearly lower the incidence and mortality rates for this lethal disease.
胆囊癌在大多数白种人群中虽较为罕见，但却是北美和南美原住民以及新西兰毛利人群中最常观察到的癌症之一。在所有人群中，胆结石与胆囊癌之间都存在着很强的相关性：胆结石患者患胆囊癌的风险比无胆结石患者高出约4至5倍。在胆结石疾病发病于最初几十年的人群中，风险要高得多。肥胖也是胆结石的一个风险因素，它会增加胆囊癌的风险，高脂肪和高热量饮食的摄入同样如此。其他风险因素，如生育次数增加，也会提高胆囊癌的发病频率，这很可能是由胆结石与生育次数之间的关联所解释的。对于无症状胆结石进行预防性胆囊切除术并不能作为控制胆囊癌的合理手段，但由于腹腔镜手术技术的广泛应用，该手术在许多国家的实施频率不断增加，这无疑将降低这种致命疾病的发病率和死亡率。
