胆囊炎患者的癌症风险：一项基于全国人口的研究。
Risk of cancer in patients with cholecystitis: a nationwide population-based study.
作者信息
Lee Pei-Chang, Hu Yu-Wen, Hu Li-Yu, Chen San-Chi, Chien Sheng-Hsuan, Shen Cheng-Che, Yeh Chiu-Mei, Chen Chun-Chia, Lin Han-Chieh, Yen Sang-Hue, Tzeng Cheng-Hwai, Chen Tzeng-Ji, Liu Chia-Jen
机构信息
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan; Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
出版信息
Am J Med. 2015 Feb;128(2):185-91. doi: 10.1016/j.amjmed.2014.08.036. Epub 2014 Oct 15.
OBJECTIVE
The objective of this study was to evaluate the risk of cancer in patients diagnosed with cholecystitis and possible interactions between cholecystitis and cholecystectomy.
METHODS
A retrospective population-based cohort study was conducted among patients diagnosed with cholecystitis that were registered in the National Health Insurance Research Database in Taiwan between January 1, 2000 and December 31, 2010. Standardized incidence ratios (SIRs) were calculated to compare the incidence of cancer in these patients to that of the general population. Adjusted hazard ratios (HRs) were also calculated to investigate whether cholecystitis increased the risk for specific cancers.
RESULTS
During a median observation period of 5.4 years, 1541 cancers occurred in 20,431 patients with cholecystitis, yielding a SIR of 1.97 (95% confidence interval [CI], 1.88-2.07). A significantly greater risk of biliary tract cancer (adjusted HR 1.72; 95% CI, 1.08-2.75) was observed after adjusting for potential risk factors. In contrast, cholecystectomy was found to attenuate the cancer risk, with the reduction of adjusted HR from 2.34 (95% CI, 1.62-3.37) to 1.28 (95% CI, 0.76-2.14).
CONCLUSION
Cholecystitis is an independent risk factor to extrahepatic biliary tract cancers, whereas cholecystectomy can attenuate the cancer risk of cholecystitis.
目的
本研究的目的是评估被诊断为胆囊炎的患者患癌风险以及胆囊炎与胆囊切除术之间可能存在的相互作用。
方法
对2000年1月1日至2010年12月31日期间在台湾国民健康保险研究数据库中登记的被诊断为胆囊炎的患者进行了一项基于人群的回顾性队列研究。计算标准化发病率（SIR）以比较这些患者的癌症发病率与普通人群的发病率。还计算了调整后的风险比（HR）以调查胆囊炎是否会增加特定癌症的风险。
结果
在中位观察期5.4年期间，20431例胆囊炎患者中发生了1541例癌症，SIR为1.97（95%置信区间[CI]，1.88 - 2.07）。在对潜在风险因素进行调整后，观察到胆道癌风险显著增加（调整后的HR为1.72；95%CI，1.08 - 2.75）。相比之下，发现胆囊切除术可降低癌症风险，调整后的HR从2.34（95%CI，1.62 - 3.37）降至1.28（95%CI，0.76 - 2.14）。
结论
胆囊炎是肝外胆道癌的独立危险因素，而胆囊切除术可降低胆囊炎患者的癌症风险。
Zotero 插件