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代谢综合征与胆管癌风险:一项基于中国医院的病例对照研究。

Metabolic syndrome and the risk of cholangiocarcinoma: a hospital-based case-control study in China.

作者信息

Xiong Jianping, Lu Xin, Xu Weiyu, Bai Yi, Huang Hanchun, Bian Jin, Zhang Lei, Long Junyu, Xu Yiyao, Wang Zhenjie, Zhao Haitao

机构信息

Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China,

Health Screening Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China,

出版信息

Cancer Manag Res. 2018 Sep 24;10:3849-3855. doi: 10.2147/CMAR.S175628. eCollection 2018.

Abstract

BACKGROUND

Metabolic syndrome is regarded as a risk factor for hepatocellular carcinoma. However, no research has been conducted to investigate the association between metabolic syndrome and cholangiocarcinoma (CCA), especially in the Chinese population. Herein, a hospital-based case-control study was carried out in China to explore the association between metabolic syndrome and CCA risk.

PATIENTS AND METHODS

In this study, 303 CCA patients (136 intrahepatic cholangiocarcinoma [ICC] and 167 extrahepatic cholangiocarcinoma [ECC]) were included, who were observed at Peking Union Medical College Hospital (PUMCH), from 2002 to 2014. Healthy controls were randomly selected from the database of PUMPH Health Screening Center. We retrospectively extracted metabolic syndrome and other possible risk factors from clinical records, followed by investigation of the relationship with CCA via calculation of ORs and 95% CIs using logistic regression analysis.

RESULTS

Metabolic syndrome was significantly and positively correlated with all CCA subtypes, with adjusted ORs (AORs) of 0.35 (95% CI =0.29-0.42) and 0.29 (95% CI =0.19-0.44) for ICC and ECC, respectively (both <0.001). Dyslipoproteinemia harbored a stronger relationship with ICC (OR =3.16; 95% CI =2.12-4.71) than ECC (OR =1.87; 95% CI =1.27-2.77), whereas hypertension harbored a stronger association with ECC (OR =3.09; 95% CI =2.09-4.58) than ICC (OR =2.06; 95% CI =1.32-3.21). Obesity was related to both ICC and ECC, with similar ORs, while diabetes was only related to ICC (OR =4.59; 95% CI =2.78-7.58), but not ECC (OR =0.97; 95% CI =0.49-1.94).

CONCLUSION

Metabolic syndrome was significantly related to a 1.86-fold elevated CCA risk.

摘要

背景

代谢综合征被视为肝细胞癌的一个危险因素。然而,尚未开展研究来调查代谢综合征与胆管癌(CCA)之间的关联,尤其是在中国人群中。在此,在中国开展了一项基于医院的病例对照研究,以探讨代谢综合征与CCA风险之间的关联。

患者与方法

在本研究中,纳入了303例CCA患者(136例肝内胆管癌[ICC]和167例肝外胆管癌[ECC]),这些患者于2002年至2014年在北京协和医院(PUMCH)接受观察。健康对照从北京协和医院健康体检中心数据库中随机选取。我们从临床记录中回顾性提取代谢综合征及其他可能的危险因素,随后通过逻辑回归分析计算比值比(OR)和95%可信区间(CI)来研究其与CCA的关系。

结果

代谢综合征与所有CCA亚型均呈显著正相关,ICC和ECC的调整后OR(AOR)分别为0.35(95%CI = 0.29 - 0.42)和0.29(95%CI = 0.19 - 0.44)(均<0.001)。血脂异常与ICC的关系(OR = 3.16;95%CI = 2.12 - 4.71)比与ECC的关系(OR = 1.87;95%CI = 1.27 - 2.77)更强,而高血压与ECC的关联(OR = 3.09;95%CI = 2.09 - 4.58)比与ICC的关联(OR = 2.06;95%CI = 1.32 - 3.21)更强。肥胖与ICC和ECC均相关,OR值相似,而糖尿病仅与ICC相关(OR = 4.59;95%CI = 2.78 - 7.58),与ECC无关(OR = 0.97;95%CI = 0.49 - 1.94)。

结论

代谢综合征与CCA风险升高1.86倍显著相关。

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