Cha Byung Hyo
Department of Gastroenterology, Division of Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE; Digestive Disease Center, Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea E-mail :
Asian Pac J Cancer Prev. 2015;16(18):8451-4. doi: 10.7314/apjcp.2015.16.18.8451.
Gallbladder cancer (GBC) is a rare but highly invasive malignancy characterized by poor survival. In a national cancer survey, the age-standardized incidence rate of GBC was highest in Jeju Island among the 15 provinces in South Korea. The aim of this descriptive epidemiological study was to suggest the modifiable risk factors for this rare malignant disease in Jeju Island by performing an age-sex-matched case- control study.
The case group included patients diagnosed with GBC at the Department of Internal Medicine of Cheju Halla General Hospital, Jeju, South Korea, within the 5-year study period. The control group consisted of age-sex-matched subjects selected from among the participants of the health promotion center at the same institute and in the same period. We compared 78 case-control pairs in terms of clinical variables such as histories of hypertension, diabetes, vascular occlusive disorders, alcohol and smoking consumption, obesity, and combined polypoid lesions of the gallbladder (PLG) or gallstone diseases (GSDs).
Among the relevant risk factors, alcohol consumption, parity ≥ 2, PLG, and GSDs were significant risk factors in the univariate analysis. PLG (p < 0.01; OR, 51.1; 95% confidence interval [CI], 2.98-875.3) and GSD (p < 0.01; OR, 54.9; 95% CI, 3.00-1001.8) were associated risk factors of GBC in the multivariate analysis with the conditional logistic regression model. However, we failed to find any correlation between obesity and GBC. We also found a negative correlation between alcohol consumption history and GBC in the multivariate analysis (p < 0.01; OR, 0.06; 95% CI, 0.01-0.31).
These results suggest that combined PLG and GSDs are strongly associated with the GBC in Jeju Island and mild to moderate alcohol consumption may negatively correlate with GBC risk.
胆囊癌（GBC）是一种罕见但侵袭性很强的恶性肿瘤，其特点是生存率低。在一项全国癌症调查中，韩国15个省份中济州岛的胆囊癌年龄标准化发病率最高。这项描述性流行病学研究的目的是通过进行年龄-性别匹配的病例对照研究，找出济州岛这种罕见恶性疾病的可改变风险因素。
病例组包括在韩国济州济州市汉拿综合医院内科在5年研究期内被诊断为胆囊癌的患者。对照组由同期从同一机构健康促进中心的参与者中选取的年龄-性别匹配的对象组成。我们比较了78对病例对照在高血压、糖尿病、血管闭塞性疾病、饮酒和吸烟史、肥胖以及胆囊息肉样病变（PLG）或胆结石疾病（GSD）等临床变量方面的情况。
在相关风险因素中，饮酒、生育次数≥2次、PLG和GSD在单因素分析中是显著风险因素。在多因素分析中，采用条件逻辑回归模型，PLG（p<0.01；比值比[OR]，51.1；95%置信区间[CI]，2.98 - 875.3）和GSD（p<0.01；OR，54.9；95%CI，3.00 - 1001.8）是胆囊癌的相关风险因素。然而，我们未发现肥胖与胆囊癌之间存在任何关联。在多因素分析中我们还发现饮酒史与胆囊癌呈负相关（p<0.01；OR，0.06；95%CI，0.01 - 0.31）。
这些结果表明在济州岛，PLG和GSD与胆囊癌密切相关，轻度至中度饮酒可能与胆囊癌风险呈负相关。
