Tominaga S, Kuroishi T
Research Institute, Aichi Cancer Center, Nagoya, Japan.
Cancer Surv. 1994;19-20:125-37.
Biliary tract cancer is a rare cancer in most parts of the world, but it is relatively common in some countries and ethnic groups, such as Japan, Central and South America, eastern Europe and in American Indians, and Hispanics. In some countries, such as Japan, Sweden, Finland and Italy, the age adjusted mortality of biliary tract cancer has been increasing, whereas in females in some other countries--Israel, The Netherlands, USA, Canada, Federal Republic of Germany, etc--mortality has been declining. The reasons for these geographical or ethnic variations and time trends for biliary tract cancer are not clear, but some unknown environmental risk factors or a genetic susceptibility are suspected. Not many analytical epidemiological studies on biliary tract cancer have been conducted yet and little is known about its aetiology apart from a close association with gall stones and a female preponderance of gall bladder cancer. Besides gall stones, some other factors such as obesity, pregnancy, female sex hormones, exposure in rubber and some other chemical industries and genetic factors have been suspected of being associated with gall bladder cancer directly or indirectly through cholelithiasis. As an artificial factor, the effect of the prevalence of cholecystectomy on biliary tract cancer must be considered. More studies are needed in the future to elucidate the aetiology of biliary tract cancer and to establish measures to prevent this cancer.
在世界大部分地区，胆道癌是一种罕见的癌症，但在一些国家和族群中相对常见，如日本、中南美洲、东欧以及美洲印第安人和西班牙裔。在一些国家，如日本、瑞典、芬兰和意大利，经年龄调整后的胆道癌死亡率一直在上升，而在其他一些国家的女性中——以色列、荷兰、美国、加拿大、德意志联邦共和国等——死亡率一直在下降。胆道癌这些地理或种族差异以及时间趋势的原因尚不清楚，但怀疑存在一些未知的环境风险因素或遗传易感性。目前关于胆道癌的分析性流行病学研究开展得并不多，除了与胆结石密切相关以及胆囊癌女性居多外，对其病因知之甚少。除了胆结石，一些其他因素，如肥胖、怀孕、女性性激素、橡胶及其他一些化工行业的接触以及遗传因素，被怀疑直接或间接通过胆石症与胆囊癌有关。作为一个人为因素，胆囊切除术的流行对胆道癌的影响必须加以考虑。未来需要更多研究来阐明胆道癌的病因并制定预防这种癌症的措施。
