Kamisawa Terumi, Munakata Wataru, Tu Yuyang, Egawa Naoto, Tsuruta Kouji, Okamoto Atsutake
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Bunkyo-ku, Tokyo 113-8677, Japan.
Hepatogastroenterology. 2008 Jan-Feb;55(81):21-3.
BACKGROUND/AIMS: Gallbladder cancer predominantly affects women; this sex-based difference is influenced by factors such as gallstones, sex hormone and genetic susceptibility. Gallbladder cancer is also frequently associated with pancreaticobiliary maljunction (PBM) without biliary dilatation. We examined sex-based differences in gallbladder cancer associated with PBM.
With a particular focus on gender differences, we retrospectively compared clinicopathological findings between 44 patients (9 men, 35 women) with PBM without biliary dilatation and 232 patients (60 men, 172 women) with gallbladder cancer that was not associated with PBM.
Gallbladder cancer was detected in 75% of patients with PBM without biliary dilatation. Among PBM patients, gallbladder cancer was significantly more common in women than in men [29/35 (83%) us. 4/9 (44%), p<0.05]. Both men and women with gallbladder cancer associated with PBM were significantly younger at the time of diagnosis than patients with gallbladder cancer without PBM (p<0.01). Gallstones were detected in only 10% of women with gallbladder cancer with PBM, while gallstones were detected in 63% of women with gallbladder cancer without PBM (p<0.01).
Gallbladder cancer occurs very frequently in patients with PBM without biliary dilatation, and women appear to be at a significantly higher risk than men.
背景/目的：胆囊癌主要影响女性；这种基于性别的差异受胆结石、性激素和遗传易感性等因素影响。胆囊癌也常与无胆管扩张的胰胆管合流异常（PBM）相关。我们研究了与PBM相关的胆囊癌的性别差异。
特别关注性别差异，我们回顾性比较了44例无胆管扩张的PBM患者（9例男性，35例女性）和232例与PBM无关的胆囊癌患者（60例男性，172例女性）的临床病理特征。
75%无胆管扩张的PBM患者检测出胆囊癌。在PBM患者中，胆囊癌在女性中比在男性中更常见[29/35（83%）对4/9（44%），p<0.05]。与PBM相关的胆囊癌患者在诊断时的年龄显著低于无PBM的胆囊癌患者（p<0.01）。在伴有PBM的胆囊癌女性患者中仅10%检测出胆结石，而在无PBM（不伴有PBM）的胆囊癌女性患者中63%检测出胆结石（p<0.01）。
无胆管扩张的PBM患者中胆囊癌的发生率非常高，而且女性的风险似乎明显高于男性。
