Vernick L J, Kuller L H
Am J Epidemiol. 1982 Jul;116(1):86-101. doi: 10.1093/oxfordjournals.aje.a113405.
One hundred fifty patients with right-side colon cancer (i.e., patients with adenocarcinoma of the cecum or ascending colon) were compared to 150 matched left-side colon cancer controls (i.e., patients with adenocarcinoma of the descending or sigmoid colon) and to 123 neighborhood controls, Pittsburgh, Pennsylvania, Standard Metropolitan Statistical Area, 1975-1978. The gastrointestinal surgical history was ascertained for all study subjects so that the presence or absence of a history of cholecystectomy could be noted. Cholecystectomy history was obtained through telephone interviews and whenever possible subsequently validated from operative and pathology reports at time of cholecystectomy. Cholecystectomy history for the colon cancer patients was also abstracted from hospital records at time of colon cancer diagnosis with an attempt to confirm the gallbladder's status through operative reports, cholecystograms, and physical examinations. Hospital records and interviews for the colon cancer patients appeared to provide accurate exposure history. Point estimates of the odds ratios and confidence intervals for intra- and inter-data source comparisons (i.e., hospital records, interviews, and hospital records and interviews combined) were comparable with similar measures of effect. Consistent odds ratio estimates appeared in both left-side colon cancer controls (1.9) and neighborhood controls (1.89). The authors suggest that changes in bile acid metabolism following cholecystectomy may be associated an increased risk of right-side colon cancer.
150例右侧结肠癌患者(即盲肠或升结肠癌腺癌患者)与150例匹配的左侧结肠癌对照者(即降结肠或乙状结肠癌腺癌患者)以及123例社区对照者进行了比较,研究地点为宾夕法尼亚州匹兹堡标准大都市统计区,时间为1975 - 1978年。对所有研究对象的胃肠道手术史进行了确定,以便记录有无胆囊切除术史。胆囊切除术史通过电话访谈获得,并尽可能随后从胆囊切除术时的手术和病理报告中进行验证。结肠癌患者的胆囊切除术史也从结肠癌诊断时的医院记录中提取,并试图通过手术报告、胆囊造影和体格检查来确认胆囊状况。结肠癌患者的医院记录和访谈似乎提供了准确的暴露史。数据来源内部和之间比较(即医院记录、访谈以及医院记录和访谈相结合)的比值比点估计值和置信区间与类似的效应测量值相当。左侧结肠癌对照者(1.9)和社区对照者(1.89)中均出现了一致的比值比估计值。作者认为,胆囊切除术后胆汁酸代谢的变化可能与右侧结肠癌风险增加有关。