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胆结石、胆囊切除术与胃癌风险

Gallstone, cholecystectomy and risk of gastric cancer.

作者信息

Kang Sung Hwa, Kim Young Hoon, Roh Young Hoon, Kim Kwan Woo, Choi Chan Joong, Kim Min Chan, Kim Su Jin, Kwon Hee Jin, Cho Jin Han, Jang Jin Seok, Lee Jong Hun

机构信息

Department of Surgery, Dong-A University Hospital, Busan, Korea.

Department of Radiology, Dong-A University Hospital, Busan, Korea.

出版信息

Ann Hepatobiliary Pancreat Surg. 2017 Aug;21(3):131-137. doi: 10.14701/ahbps.2017.21.3.131. Epub 2017 Aug 31.

Abstract

BACKGROUNDS/AIMS: The aim of this retrospective study is to compare stomach cancer incidence, characteristics between gallstones, cholecystectomy and control groups. It also aims to investigate key variables' potential effects on overall survival.

METHODS

A total of 99 patients, diagnosed with stomach cancers between April 1994 and December 2015, were identified. We excluded stomach cancer patients, accrued during the first year of follow-up in both the gallstones and cholecystectomy groups, assuming that they missed cancers. The main analyses addressing the objective were a chi-square analysis and a survival analysis.

RESULTS

The incidence of stomach cancers was increased in both the gallstone and cholecystectomy groups, compared with the control group (=0.003). Multivariate regression analysis showed that the overall survival in gallstones, cholecystectomy group patients as compared with those in the control group decreased (HR=6.66, 95 CI: 1.94-22.80, =0.003). Also, T-stage was found to statistically affect the rate of overall survival (HR=9.85, 95% CI: 3.09-31.39, =.000). The stomach cancer showed the worse survival at the posterior, greater curvature location than anterior, lesser curvature of the stomach. (HR=0.30, 95% CI: 0.11-0.80, =0.017).

CONCLUSIONS

We provided an awareness of the possible increased risks of stomach cancer in gallstone and cholecystectomy group patients, which might be induced by duodenogastric bile reflux. Also, the survival rate was poor (<0.000). Therefore, close follow-up strategies for early detection are recommended for such patients.

摘要

背景/目的:本回顾性研究旨在比较胃癌发病率、胆结石组、胆囊切除术组与对照组之间的特征。同时,研究关键变量对总生存期的潜在影响。

方法

共纳入1994年4月至2015年12月期间诊断为胃癌的99例患者。我们排除了胆结石组和胆囊切除术组随访第一年确诊的胃癌患者,假定他们此前漏诊了癌症。针对该目标的主要分析方法为卡方分析和生存分析。

结果

与对照组相比,胆结石组和胆囊切除术组的胃癌发病率均有所升高(P=0.003)。多因素回归分析显示,与对照组相比,胆结石组和胆囊切除术组患者的总生存期缩短(风险比=6.66,95%置信区间:1.94-22.80,P=0.003)。此外,发现T分期对总生存率有统计学影响(风险比=9.85,95%置信区间:3.09-31.39,P=0.000)。胃癌在胃后壁、大弯侧的生存率低于胃前壁、小弯侧(风险比=0.30,95%置信区间:0.11-0.80,P=0.017)。

结论

我们提醒注意胆结石组和胆囊切除术组患者患胃癌的风险可能增加,这可能是由十二指肠-胃胆汁反流引起的。此外,生存率较低(P<0.000)。因此,建议对此类患者采取密切随访策略以实现早期发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61de/5620473/cc1904859265/ahbps-21-131-g001.jpg

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