Chen C C, Neugut A I, Rotterdam H
School of Public Health, College of Physicians and Surgeons, Columbia University, New York, New York 10032.
Cancer Epidemiol Biomarkers Prev. 1994 Apr-May;3(3):205-7.
Although the small intestine contains 75% of the mucosal surface of the gastrointestinal tract, it is the site of only 2% as many malignancies as the large bowel. The association of Crohn's disease with small intestine adenocarcinoma is well known, but the analytic epidemiology of small intestine malignancies has not received much attention. We reviewed the medical records of 19 patients with adenocarcinoma and 17 with malignant carcinoids identified from the Columbia-Presbyterian Medical Center Tumor Registry in the years 1980-1987. These were compared with 52 controls with nonmalignant conditions from the same time period. Three adenocarcinoma patients but no carcinoid patients or controls had previous Crohn's disease (P < 0.004). Three adenocarcinomas and three carcinoids, but no controls, had previous cholecystectomy (P < 0.004). Previous peptic ulcer disease was recorded for two patients with adenocarcinoma and three with carcinoid but no controls (P < 0.02, P < 0.0002). The age and sex adjusted odds ratio for cigarette smoking was 4.6 (95% confidence interval, 1.0-20.7) for adenocarcinomas and 4.2 (0.8-22.4) for carcinoids. The adjusted odds ratio for alcohol consumption was 4.0 (1.0-15.9) for adenocarcinomas and 3.1 (0.7-13.9) for carcinoids. Further studies are warranted to confirm these associations and to identify potential protective factors in the small intestine.
尽管小肠占胃肠道黏膜表面积的75%，但其恶性肿瘤的发生部位仅占大肠的2%。克罗恩病与小肠腺癌的关联已为人熟知，但小肠恶性肿瘤的分析流行病学尚未受到太多关注。我们回顾了1980 - 1987年间从哥伦比亚长老会医学中心肿瘤登记处确定的19例腺癌患者和17例恶性类癌患者的病历。将这些患者与同期52例非恶性疾病的对照者进行比较。3例腺癌患者有既往克罗恩病病史，而类癌患者和对照者均无（P < 0.004）。3例腺癌患者和3例类癌患者有既往胆囊切除术史，对照者无（P < 0.004）。2例腺癌患者和3例类癌患者有既往消化性溃疡病史，对照者无（P < 0.02，P < 0.0002）。腺癌患者吸烟的年龄和性别调整后的优势比为4.6（95%置信区间，1.0 - 20.7），类癌患者为4.2（0.8 - 22.4）。腺癌患者饮酒的调整后优势比为4.0（1.0 - 15.9），类癌患者为3.1（0.7 - 13.9）。有必要进行进一步研究以证实这些关联，并确定小肠中的潜在保护因素。
