胆管癌与石棉职业暴露：来自意大利汇总队列研究的新见解。
Cholangiocarcinoma and Occupational Exposure to Asbestos: Insights From the Italian Pooled Cohort Study.
机构信息
Department of Medical and Surgical Sciences, University of Bologna, Italy.
Unit of Medical Statistics, Department of Translational Medicine, Università del Piemonte Orientale and Cancer Epidemiology Unit, CPO-Piemonte, Novara, Italy.
出版信息
Med Lav. 2024 Apr 24;115(2):e2024016. doi: 10.23749/mdl.v115i2.14649.
BACKGROUND
Recent studies supported the association between occupational exposure to asbestos and risk of cholangiocarcinoma (CC). Aim of the present study is to investigate this association using an update of mortality data from the Italian pooled asbestos cohort study and to test record linkage to Cancer Registries to distinguish between hepatocellular carcinoma (HCC) and intrahepatic/extrahepatic forms of CC.
METHODS
The update of a large cohort study pooling 52 Italian industrial cohorts of workers formerly exposed to asbestos was carried out. Causes of death were coded according to ICD. Linkage was carried out for those subjects who died for liver or bile duct cancer with data on histological subtype provided by Cancer Registries.
RESULTS
47 cohorts took part in the study (57,227 subjects). We identified 639 causes of death for liver and bile duct cancer in the 44 cohorts covered by Cancer Registry. Of these 639, 240 cases were linked to Cancer Registry, namely 14 CC, 83 HCC, 117 cases with unspecified histology, 25 other carcinomas, and one case of cirrhosis (likely precancerous condition). Of the 14 CC, 12 occurred in 2010-2019, two in 2000-2009, and none before 2000.
CONCLUSION
Further studies are needed to explore the association between occupational exposure to asbestos and CC. Record linkage was hampered due to incomplete coverage of the study areas and periods by Cancer Registries. The identification of CC among unspecific histology cases is fundamental to establish more effective and targeted liver cancer screening strategies.
背景
最近的研究支持职业性接触石棉与胆管癌（CC）风险之间的关联。本研究的目的是使用意大利 pooled 石棉队列研究的死亡率数据更新来调查这种关联，并测试与癌症登记处的记录链接，以区分肝细胞癌（HCC）和肝内/肝外胆管癌的形式。
方法
对汇集了 52 个意大利工业石棉暴露工人队列的大型队列研究进行了更新。死因按照 ICD 编码。对于因肝或胆管癌死亡的患者进行链接，并由癌症登记处提供组织学亚型的数据。
结果
有 47 个队列参加了这项研究（57227 名受试者）。我们在覆盖癌症登记处的 44 个队列中发现了 639 例肝和胆管癌死因。在这 639 例中，有 240 例与癌症登记处相关联，即 14 例 CC、83 例 HCC、117 例组织学不明、25 例其他癌和 1 例肝硬化（可能为癌前病变）。14 例 CC 中，12 例发生在 2010-2019 年，2 例发生在 2000-2009 年，2000 年之前没有发生过。
结论
需要进一步研究来探讨职业性接触石棉与 CC 之间的关联。记录链接受到癌症登记处研究区域和时期覆盖不完整的阻碍。在组织学不明病例中识别 CC 对于制定更有效和有针对性的肝癌筛查策略至关重要。
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