Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Aliment Pharmacol Ther. 2012 Sep;36(5):467-76. doi: 10.1111/j.1365-2036.2012.05212.x. Epub 2012 Jul 10.
There has been no large-scale population-based study on the relationship between pyogenic liver abscesses (PLA) and subsequent cancer risk.
To estimate all cancer risk following a diagnosis of PLA.
Based on Taiwan's National Health Insurance Research Database, 1257 patients with PLA without prior cancers in the period 1996-2008 were identified and followed-up. The standard incidence ratio (SIR) of each cancer was calculated as the number of observed cancer cases arising among the PLA patients divided by the expected case number of cancer cases according to the national cancer rates.
Of the 1257 PLA patients identified, 598 (47.6%) had diabetes mellitus. After a median (±s.d.) follow-up of 3.33 ± 3.45 years, 186 were diagnosed with cancers, including 56 liver cancer, 22 biliary tract cancer and 40 colorectal cancer patients. Patients with PLA had a higher risk of all cancers (SIR, 3.83; 95% CI, 3.30-4.42), liver cancer (SIR, 7.87; 95% CI, 5.94-10.21), biliary tract cancer (SIR, 34.58; 95% CI, 21.67-52.36) and colorectal cancer (SIR, 5.27; 95% CI, 3.76-7.18). The highest SIRs of all cancers, liver cancer, biliary tract cancer and colorectal cancer occurred within 90 days of follow-up (360.82; 95% CI, 278.46-459.91, 257.28; 95% CI, 186.17-346.56, 1153.38; 95% CI 694.08-1801.24, and 52.63; 95% CI 25.2-96.8 respectively).
Pyogenic liver abscesses may herald the onset of cancer, especially hepato-biliary and colon cancer. Further surveys should be conducted for the detection of occult cancers in such patients.
目前还没有大规模基于人群的研究探讨化脓性肝脓肿（PLA）与随后的癌症风险之间的关系。
评估 PLA 诊断后所有癌症的风险。
基于台湾全民健康保险研究数据库，在 1996 年至 2008 年间，我们确定了 1257 例无既往癌症的 PLA 患者，并对其进行随访。每个癌症的标化发病比（SIR）计算为 PLA 患者中发生的观察到的癌症病例数除以根据全国癌症发病率计算出的预期癌症病例数。
在所确定的 1257 例 PLA 患者中，598 例（47.6%）患有糖尿病。在中位（±标准差）3.33±3.45 年的随访后，186 例被诊断患有癌症，包括 56 例肝癌、22 例胆管癌和 40 例结直肠癌患者。PLA 患者的所有癌症（SIR，3.83；95%CI，3.30-4.42）、肝癌（SIR，7.87；95%CI，5.94-10.21）、胆管癌（SIR，34.58；95%CI，21.67-52.36）和结直肠癌（SIR，5.27；95%CI，3.76-7.18）风险均较高。所有癌症、肝癌、胆管癌和结直肠癌的最高 SIR 均在随访的 90 天内发生（360.82；95%CI，278.46-459.91，257.28；95%CI，186.17-346.56，1153.38；95%CI 694.08-1801.24，52.63；95%CI 25.2-96.8）。
化脓性肝脓肿可能预示着癌症的发生，尤其是肝胆癌和结肠癌。应进一步进行调查，以发现此类患者的隐匿性癌症。
