胆囊切除术与结直肠癌

Cholecystectomy and colorectal cancer.

作者信息

Ekbom A, Yuen J, Adami H O, McLaughlin J K, Chow W H, Persson I, Fraumeni J F

机构信息

Cancer Epidemiology Unit, University Hospital, Uppsala, Sweden.

出版信息

Gastroenterology. 1993 Jul;105(1):142-7. doi: 10.1016/0016-5085(93)90019-9.

DOI:10.1016/0016-5085(93)90019-9

PMID:8514031

Abstract

BACKGROUND

An increased risk of large bowel cancer, especially of the right colon, following cholecystectomy has been reported in some studies but contradicted in others. The aim of this study was to settle this question by creating a cohort of cholecystectomy patients that was large enough and with a sufficient follow-up time to detect even weak associations.

METHODS

A population-based cohort consisting of 62,615 patients who underwent cholecystectomy was followed up for the occurrence of colorectal cancer up to 23 years.

RESULTS

There were 633 colorectal cancers versus 637.9 expected (standardized incidence ratio [SIR] = 0.99; 95% confidence interval [CI] = 0.92-1.07). Analyses of an extensive number of subgroups including sex, age at operation, duration of follow-up, underlying diagnosis, type of operation, and different cancer sites did not show any association. However, for cancer of the right colon among women, the risk was increased (SIR = 1.24; 95% CI = 1.03-1.48) most prominent 15 years or more after operation (SIR = 1.54; 95% CI = 1.03-2.22).

CONCLUSIONS

Overall, there is no excess risk of colorectal cancer following cholecystectomy, but consistent with some earlier reports, we observed an increased risk among women for right-sided colon cancer 15 years or more after operation.

摘要

背景

一些研究报告称，胆囊切除术后患大肠癌尤其是右半结肠癌的风险增加，但其他研究则持相反观点。本研究的目的是通过建立一个足够大且随访时间足够长的胆囊切除术患者队列来解决这一问题，以便即使是微弱的关联也能被发现。

方法

对一个由62615例接受胆囊切除术的患者组成的基于人群的队列进行随访，观察长达23年的结直肠癌发生情况。

结果

共发生633例结直肠癌，预期发生637.9例（标准化发病比[SIR]=0.99；95%置信区间[CI]=0.92-1.07）。对包括性别、手术年龄、随访时间、基础诊断、手术类型和不同癌症部位在内的大量亚组进行分析，未发现任何关联。然而，对于女性右半结肠癌，风险增加（SIR=1.24；95%CI=1.03-1.48），在术后15年或更长时间最为显著（SIR=1.54；95%CI=1.03-2.22）。