乙状结肠憩室炎与左侧结肠癌之间的关联：一项基于人群的巢式病例对照研究。

Association between sigmoid diverticulitis and left-sided colon cancer: a nested, population-based, case control study.

作者信息

Stefánsson T, Ekbom A, Sparèn P, Påhlman L

机构信息

Dept. of Surgery, University Hospital, Uppsala, Sweden.

出版信息

Scand J Gastroenterol. 2004 Aug;39(8):743-7. doi: 10.1080/00365520410003272.

DOI:10.1080/00365520410003272

PMID:15513359

Abstract

BACKGROUND

An increased risk of left-sided colon cancer in patients with diverticular disease of the sigmoid colon has been reported. The aim of this study was to investigate to what extent patients with diverticulitis of the sigmoid colon differ in long-term risk of colon cancer compared to patients with diverticulosis of the colon without any clinical signs of diverticulitis.

METHODS

A total of 7159 patients (2478 M, 4681 F) discharged with a diagnosis of diverticulosis or diverticulitis in 1965-83 in the Uppsala Health Care Region were followed-up with the Swedish Cancer Registry. Sixty-four cases with colon cancer were identified and compared with 123 controls without cancer matched for sex, age and year of first discharge. Based on information from the patients' charts, an independent observer blinded to the outcome assigned a clinical diagnosis of diverticulitis or not diverticulitis to cases and controls.

RESULTS

In patients classified as having sigmoid diverticulitis there was an increased risk of left-sided colon cancer compared with patients with diverticulosis without any clinical signs of diverticulitis (odds ratio = 4.2, 95% CI 1.3-13.0) which remained after mutually adjusting for several clinical parameters in a multivariate conditional logistic regression analysis.

CONCLUSION

The results of the study indicate a causal association between sigmoid diverticulitis and a long-term increased risk of left-sided colon cancer.

摘要

背景

据报道，乙状结肠憩室病患者患左侧结肠癌的风险增加。本研究的目的是调查与无任何憩室炎临床症状的结肠憩室病患者相比，乙状结肠憩室炎患者在结肠癌长期风险方面的差异程度。

方法

1965年至1983年在乌普萨拉医疗保健地区出院诊断为结肠憩室病或憩室炎的7159名患者（2478名男性，4681名女性），通过瑞典癌症登记处进行随访。确定了64例结肠癌病例，并与123例无癌症的对照进行比较，这些对照在性别、年龄和首次出院年份上进行了匹配。根据患者病历中的信息，一名对结果不知情的独立观察者对病例和对照进行了憩室炎或非憩室炎的临床诊断。