Huang Wen-Kuan, Lin Yung-Chang, Chiou Meng-Jiun, Yang Tsai-Sheng, Chang John Wen-Cheng, Yu Kuang-Hui, Kuo Chang-Fu, See Lai-Chu
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan E-mail :
Asian Pac J Cancer Prev. 2013;14(8):4727-31. doi: 10.7314/apjcp.2013.14.8.4727.
There have been no large-scale population-based studies to estimate the subsequent risk of primary liver cancer (PLC) among patients with pyogenic liver abscess (PLA). This study aimed to provide relevant data.
The Taiwan Longitudinal Health Insurance Database for the years 2000 and 2005 was used. The PLA group were adult inpatients who were newly diagnosed with PLA from 2000 to 2008. The control group was randomly selected and matched with the PLA group in terms of age, sex, and date in which medical treatment was sought other than for PLA.
There were 1,987 patients each in the PLA and control groups. In total, 56 had PLC, 48 (2.4%, 601.5 per 100,000 person-years) from the PLA group, and 8 from the control group. After adjusting for potential covariates, the hazard ratio of PLC for the PLA group was 3.4 times that of the control group (95% confidence interval = 1.6-7.3, p <0.001). The PLC risk for the PLA group was significantly higher within the first year after PLA diagnosis (hazard ratio: 35.4) as compared with the control group and became insignificant (hazard ratio: 2.0, 95% confidence interval = 0.8-4.9) more than one year after PLA diagnosis.
Patients with PLA have a higher rate of PLC than matched controls, especially within the first year after the diagnosis of PLA, suggesting PLA is a warning sign for PLC.
目前尚无基于大规模人群的研究来评估化脓性肝脓肿（PLA）患者后续发生原发性肝癌（PLC）的风险。本研究旨在提供相关数据。
使用了2000年和2005年的台湾纵向健康保险数据库。PLA组为2000年至2008年新诊断为PLA的成年住院患者。对照组通过随机选择，并在年龄、性别以及除PLA之外寻求医疗治疗的日期方面与PLA组进行匹配。
PLA组和对照组各有1987例患者。共有56例发生PLC，其中PLA组48例（2.4%，每10万人年601.5例），对照组8例。在对潜在协变量进行调整后，PLA组发生PLC的风险比是对照组的3.4倍（95%置信区间 = 1.6 - 7.3，p < 0.001）。与对照组相比，PLA组在PLA诊断后的第一年内发生PLC的风险显著更高（风险比：35.4），而在PLA诊断一年多后则无显著差异（风险比：2.0，95%置信区间 = 0.8 - 4.9）。
PLA患者发生PLC的比率高于匹配的对照组，尤其是在PLA诊断后的第一年内，这表明PLA是PLC的一个警示信号。
