Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Cancer Epidemiol Biomarkers Prev. 2018 Mar;27(3):348-351. doi: 10.1158/1055-9965.EPI-17-1003. Epub 2018 Jan 16.
Although some familial cancer syndromes include biliary tract cancers (BTCs; cancers of the gallbladder, intrahepatic and extrahepatic bile ducts, and ampulla of Vater), the few studies that have examined the relationships between family history of cancer (FHC) and BTCs have reported inconclusive findings. The objective of this study was to investigate the associations of FHC with risk of BTC in the Biliary Tract Cancers Pooling Project (BiTCaPP). We used Cox proportional hazards regressions models to estimate HRs and 95% confidence intervals for associations between FHC (any, first-degree, in female relative, in male relative, relative with gastrointestinal cancer, and relative with hormonally related cancer) and BTC risk by anatomic site within the biliary tract, adjusting for sex and race/ethnicity. Sensitivity analyses were conducted that restricted to studies reporting cholecystectomy data and to people without a history of cholecystectomy. Data on FHC were available from 12 prospective studies within BiTCaPP, which collectively contributed 2,246 cases (729 gallbladder, 345 intrahepatic and 615 extrahepatic bile duct, and 385 ampulla of Vater cancers) with 21,706,107 person-years of follow-up. A marginal, inverse association between FHC and gallbladder cancer was driven to the null when analysis was restricted to studies reporting cholecystectomy data and to people without a history of cholecystectomy. FHC was not associated with risk of BTC at the other anatomic sites. These findings do not support an association between FHC and BTCs. In a study of 1.5 million people, FHC is not a risk factor for BTCs. .
虽然一些家族性癌症综合征包括胆道癌（BTC；胆囊、肝内和肝外胆管以及 Vater 壶腹的癌症），但少数研究癌症家族史（FHC）与 BTC 之间关系的研究报告结果尚无定论。本研究旨在调查 Biliary Tract Cancers Pooling Project (BiTCaPP) 中 FHC 与 BTC 风险之间的关联。我们使用 Cox 比例风险回归模型，估计了 FHC（任何、一级、女性亲属、男性亲属、胃肠道癌亲属和激素相关癌症亲属）与 BTC 风险之间的 HR 和 95%置信区间，按胆道解剖部位进行调整，包括性别和种族/民族。进行了敏感性分析，这些分析仅限于报告胆囊切除术数据的研究和没有胆囊切除术史的人群。FHC 数据来自 BiTCaPP 中的 12 项前瞻性研究，这些研究共提供了 2246 例病例（729 例胆囊癌、345 例肝内胆管癌、615 例肝外胆管癌和 385 例 Vater 壶腹癌），随访时间为 21706107 人年。当分析仅限于报告胆囊切除术数据的研究和没有胆囊切除术史的人群时，FHC 与胆囊癌之间的边缘负相关关系趋近于零。FHC 与其他解剖部位的 BTC 风险无关。这些发现不支持 FHC 与 BTC 之间存在关联。在一项对 150 万人的研究中，FHC 不是 BTC 的危险因素。
