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[阑尾切除术、胆囊切除术、胆结石与结直肠癌。在科多尔省进行的一项回顾性病例对照研究]

[Appendectomy, cholecystectomy, cholelithiasis and colorectal cancer. A retrospective case control study at the Côte-d'Or].

作者信息

Grobost O, Boutron M C, Arveux P, Bedenne L, Chatrenet P, Faivre J

机构信息

Registre des Tumeurs Digestives, Faculté de Médecine, Dijon.

出版信息

Gastroenterol Clin Biol. 1991;15(8-9):594-9.

PMID:1752369
Abstract

Several studies have shown that there might be a relationship between previous history of appendectomy or cholecystectomy and the subsequent risk of colorectal cancer. In order to investigate these hypotheses, a case-control study was set up to compare the history of appendectomy and cholecystectomy as well as the presence of cholelithiasis in patients with colorectal carcinoma vs patients with gastric carcinoma. The study was performed in the 727 patients included in the Registry of Digestive Cancers of the Côte d'Or and treated at the Dijon University Hospital during the period 1981-1987. These patients were well matched to those of the whole registry population for sex, age, stage, and residence distributions. In females, in comparison to the gastric cancer patients, a personal history of appendectomy was more commonly observed in case of right colonic cancer (odds ratio: 3.5; P less than 0.01) and a personal history of cholecystectomy in case of left colonic cancer, in particular when considering only those earlier than 10 years (odds ratio: 3.2; P less than 0.05). In contrast, the risk of rectal cancer was lower in case of a cholecystectomy performed more than 10 years earlier (odds ratio: 0.2; NS) and in case of cholelithiasis (odds ratio: 0.4; P less than 0.05). In males, there was no difference between cases and controls as for the proportion of appendectomies, cholecystectomies or cholelithiasis. These observations are consistent with the hypothesis that the appendix as a lymphoid organ plays a protective role in colon carcinogenesis, in particular in women.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

多项研究表明,既往阑尾切除术或胆囊切除术史与随后患结直肠癌的风险之间可能存在关联。为了探究这些假设,开展了一项病例对照研究,以比较结直肠癌患者与胃癌患者的阑尾切除术和胆囊切除术史以及胆石症的存在情况。该研究在1981年至1987年期间纳入科多尔省消化癌症登记处并在第戎大学医院接受治疗的727例患者中进行。这些患者在性别、年龄、分期和居住分布方面与整个登记人群的患者匹配良好。在女性中,与胃癌患者相比,右结肠癌患者更常出现阑尾切除术个人史(比值比:3.5;P<0.01),左结肠癌患者更常出现胆囊切除术个人史,尤其是仅考虑那些手术时间早于10年的情况时(比值比:3.2;P<0.05)。相比之下,10年以上前进行胆囊切除术的患者患直肠癌的风险较低(比值比:0.2;无统计学意义),有胆石症的患者也是如此(比值比:0.4;P<0.05)。在男性中,病例组和对照组在阑尾切除术、胆囊切除术或胆石症的比例方面没有差异。这些观察结果与阑尾作为淋巴器官在结肠癌发生中起保护作用的假设一致,尤其是在女性中。(摘要截短至250字)

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