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胆囊切除术后乳腺癌风险无增加。

No increased risk of breast cancer after cholecystectomy.

作者信息

Lagergren J, Ye W, Ekbom A

机构信息

Division of Surgery, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.

出版信息

Int J Cancer. 2000 Nov 15;88(4):679-81. doi: 10.1002/1097-0215(20001115)88:4<679::aid-ijc25>3.0.co;2-d.

Abstract

An increased risk of breast cancer after cholecystectomy has been proposed, but the results in different studies have not been consistent. To explore this potential association, we conducted a large, population-based, record-linkage, cohort study in Sweden. The cohort consisted of 154,283 women who had been cholecystectomized during the period 1965-1994. The cohort was followed up for breast cancer by the Swedish Cancer Register. The standardized incidence ratio (SIR), the ratio of the observed to the expected number of incident cancers derived from the entire Swedish population, estimated relative risk. During a follow-up of 31 years, we observed 3,879 cases of breast cancer in the cohort vs. 3,843 expected [SIR = 1.01, 95% confidence interval (CI) 0.98-1.04]. No significant difference in risk was observed across duration of follow-up or age at follow-up. Among women followed up for more than 20 years after cholecystectomy, the observed 403 cases of breast cancer rendered an SIR of 0.96 (95% CI 0.87-1.06). The results remained virtually unchanged after controlling for possible confounding effects of obesity and diabetes. Also, we did not find any evidence of an association between gall stone disease per se and the risk of breast cancer. We conclude that cholecystectomy and breast cancer are not likely to be associated.

摘要

胆囊切除术后乳腺癌风险增加的说法已被提出,但不同研究的结果并不一致。为了探究这种潜在关联,我们在瑞典开展了一项基于人群的大型记录链接队列研究。该队列由1965年至1994年期间接受胆囊切除术的154,283名女性组成。通过瑞典癌症登记处对该队列进行乳腺癌随访。标准化发病比(SIR),即观察到的与源自整个瑞典人群的预期新发癌症病例数之比,用于估计相对风险。在31年的随访期间,我们在该队列中观察到3879例乳腺癌病例,而预期为3843例[SIR = 1.01,95%置信区间(CI)0.98 - 1.04]。在随访时间或随访年龄方面未观察到风险有显著差异。在胆囊切除术后随访超过20年的女性中,观察到的403例乳腺癌病例得出的SIR为0.96(95%CI 0.87 - 1.06)。在控制肥胖和糖尿病可能的混杂效应后,结果基本保持不变。此外,我们未发现胆结石疾病本身与乳腺癌风险之间存在关联的任何证据。我们得出结论,胆囊切除术与乳腺癌不太可能存在关联。

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