Sandler R S, Martin Z Z, Carlton N M, Holland K L
Division of Digestive Diseases and Nutrition, University of North Carolina, School of Medicine, Chapel Hill 27599-7080.
Dig Dis Sci. 1988 Sep;33(9):1178-84. doi: 10.1007/BF01535797.
Cholecystectomy has been reported to be more common in patients with colon cancer. Since adenomas are believed to be precursors of colon cancer, we evaluated the association of cholecystectomy and adenomas in a case-control study. Cases were 244 patients with one or more adenomas who underwent colonoscopy at the North Carolina Memorial Hospital between May 1983 and August 1985. Controls were 281 patients without adenomas. Overall, cholecystectomy was found in 11.9% of cases and 10.3% of controls. White women with adenomas, however, were more likely to have had previous cholecystectomy than controls [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.1-5.6]. Although women with adenomas were older and heavier than controls, the elevated odds ratio persisted after adjustment for these factors (OR 1.8; 95% CI 0.8-4.2). No association was observed for men or for nonwhite women. Cholecystectomy may predispose to colon adenomas and to colon cancer in some patients. Alternatively, common risk factors for gallstones, cholecystectomy, and colon cancer may explain the apparent risk of colon cancer or adenomas after cholecystectomy.
据报道，胆囊切除术在结肠癌患者中更为常见。由于腺瘤被认为是结肠癌的前体，我们在一项病例对照研究中评估了胆囊切除术与腺瘤之间的关联。病例为1983年5月至1985年8月间在北卡罗来纳州纪念医院接受结肠镜检查的244例有一个或多个腺瘤的患者。对照为281例无腺瘤的患者。总体而言，11.9%的病例和10.3%的对照进行过胆囊切除术。然而，患有腺瘤的白人女性比对照更有可能曾接受过胆囊切除术[比值比（OR）2.5，95%置信区间（CI）1.1 - 5.6]。尽管患有腺瘤的女性比对照年龄更大、体重更重，但在对这些因素进行调整后，升高的比值比仍然存在（OR 1.8；95% CI 0.8 - 4.2）。在男性或非白人女性中未观察到关联。胆囊切除术可能使一些患者易患结肠腺瘤和结肠癌。或者，胆结石、胆囊切除术和结肠癌的共同风险因素可能解释了胆囊切除术后患结肠癌或腺瘤的明显风险。
