Liu Tong, Siyin Sarah Tan, Yao Nan, Xu Guoshuai, Chen Yi-Tsun, Duan Ning, Li Wenqiang, Qu Jun, Liu Siqing
Department of General Surgery, Aerospace Center Hospital.
Department of General Surgery, Beijing Children's Hospital, National Center for Children's Health.
Medicine (Baltimore). 2020 Sep 25;99(39):e22428. doi: 10.1097/MD.0000000000022428.
Previous research has revealed a positive relationship between GSD, cholecystectomy and primary liver cancer (PLC). However, previous studies had several limitations including the retrospective design, narrow assessment of potential confounders and lack of competing risk models in time-to-event analyses. We conducted a large prospective cohort study to explore the relationship between GSD, cholecystectomy and PLC. A total of 95,021 participants who had not been diagnosed with PLC previously were enrolled from the Kailuan Cohort study. Demographic characteristics and biochemical parameters were recorded at baseline for all participants. We used Cox regression models and competing risk regression models to evaluate the association of GSD and cholecystectomy with the risk PLC. A total of 306 incidental PLC cases were identified during a median follow-up of 9.05 (8.75-9.22) years per participant. Compared with the normal group, the multivariable HRs (95%CI) for the association of GSD and cholecystectomy with PLC were 1.77 (1.05-2.94), 5.25 (1.95-14.17). In the CS model, the multivariable HRs (95%CI) was 1.76 (1.05-2.94) for the association of GSD and cholecystectomy with PLC and 5.25 (1.95-14.17) for GSD and cholecystectomy. Similar results were also obtained in the SD model with corresponding multivariate HRs (95%CI) of 1.75 (1.01-3.00), 5.22 (1.90-14.07) in the GSD group and cholecystectomy group, respectively. GSD and cholecystectomy were associated with an elevated risk of PLC.Registration number: ChiCTR-TNRC-11001489.
先前的研究揭示了胆囊收缩功能障碍（GSD）、胆囊切除术与原发性肝癌（PLC）之间存在正相关关系。然而，先前的研究存在一些局限性，包括回顾性设计、对潜在混杂因素的评估狭窄以及在事件发生时间分析中缺乏竞争风险模型。我们进行了一项大型前瞻性队列研究，以探讨GSD、胆囊切除术与PLC之间的关系。总共从开滦队列研究中纳入了95,021名先前未被诊断出患有PLC的参与者。在基线时记录了所有参与者的人口统计学特征和生化参数。我们使用Cox回归模型和竞争风险回归模型来评估GSD和胆囊切除术与PLC风险的关联。在每位参与者中位随访9.05（8.75 - 9.22）年期间，共识别出306例偶发性PLC病例。与正常组相比，GSD和胆囊切除术与PLC关联的多变量风险比（95%置信区间）分别为1.77（1.05 - 2.94）、5.25（1.95 - 14.17）。在竞争风险模型中，GSD和胆囊切除术与PLC关联的多变量风险比（95%置信区间）为1.76（1.05 - 2.94），GSD和胆囊切除术的多变量风险比（95%置信区间）为5.25（1.95 - 14.17）。在特定亚组模型中也获得了类似结果，GSD组和胆囊切除术组相应的多变量风险比（95%置信区间）分别为1.75（1.01 - 3.00）和5.22（1.90 - 14.07）。GSD和胆囊切除术与PLC风险升高相关。注册号：ChiCTR - TNRC - 11001489。
