Institute of Medicine, Chung Shan Medical University, Taichung City, Taiwan.
School of Medicine, Chung Shan Medical University, Taichung City, Taiwan.
J Gastroenterol Hepatol. 2021 May;36(5):1187-1196. doi: 10.1111/jgh.15234. Epub 2020 Sep 22.
Pancreatic cancer is a fatal disease; currently, the risk factor survey is not suitable for sporadic pancreatic cancer, which has neither family history nor the genetic analysis data. The aim of the present study was to evaluate the roles of cholelithiasis and cholelithiasis treatments on pancreatic cancer risk.
Symptomatic adult patients with an index admission of cholelithiasis were selected from one million random samples obtained between January 2005 and December 2009. The control group was matched with a 1:1 ratio for sex, age, chronic pancreatitis, and pancreatic cystic disease. Subsequent pancreatic cancer, which we defined as pancreatic cancer that occurred ≥ 6 months later, and total pancreatic cancer events were calculated in the cholelithiasis and control groups. The cholelithiasis group was further divided into endoscopic sphincterotomy/endoscopic papillary balloon dilatation, cholecystectomy, endoscopic sphincterotomy/endoscopic papillary balloon dilatation and cholecystectomy, and no-intervention groups for evaluation.
The cholelithiasis group and the matched control group included 8265 adults. The cholelithiasis group contained 86 cases of diagnosed pancreatic cancer, and the control group contained 8 cases (P < 0.001). The incidence rate ratio (IRR) of subsequent pancreatic cancer was significantly higher in the cholelithiasis group than in the control group (IRR: 5.28, P < 0.001). The IRR of subsequent pancreatic cancer was higher in the no-intervention group comparing with cholecystectomy group (IRR = 3.21, P = 0.039) but was similar in other management subgroups.
Symptomatic cholelithiasis is a risk factor for pancreatic cancer; the risk is similar regardless of the intervention chosen for cholelithiasis.
胰腺癌是一种致命的疾病；目前，对于散发性胰腺癌，由于没有家族史和遗传分析数据，风险因素调查并不适用。本研究旨在评估胆石症及其治疗对胰腺癌风险的作用。
从 2005 年 1 月至 2009 年 12 月期间获得的 100 万随机样本中选择有症状的成年胆石症初诊患者。对照组按照性别、年龄、慢性胰腺炎和胰腺囊性疾病进行 1:1 匹配。胆石症组和对照组均计算胆石症和对照组中后续发生的胰腺癌（我们将其定义为≥6 个月后发生的胰腺癌）和总胰腺癌事件。胆石症组进一步分为内镜下括约肌切开术/内镜乳头气囊扩张术、胆囊切除术、内镜下括约肌切开术/内镜乳头气囊扩张术和胆囊切除术以及无干预组进行评估。
胆石症组和匹配的对照组包括 8265 名成年人。胆石症组中有 86 例确诊为胰腺癌，对照组中有 8 例（P<0.001）。胆石症组后续发生胰腺癌的发病率比对照组明显更高（IRR：5.28，P<0.001）。与胆囊切除术组相比，无干预组的后续胰腺癌发生率更高（IRR=3.21，P=0.039），但在其他管理亚组中相似。
有症状的胆石症是胰腺癌的一个危险因素；无论选择何种胆石症干预措施，其风险相似。
