PANCREATITIS IS A RISK FACTOR FOR PANCREATIC-CANCER
PANCREATITIS IS A RISK FACTOR FOR PANCREATIC-CANCER
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DOI：
10.1016/0016-5085(95)90291-0
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发表时间：
1995-07-01
期刊：
影响因子：
29.4
通讯作者：
SONNENBERG, A
中科院分区：
文献类型：
--
作者：
BANSAL, P;SONNENBERG, A
背景和目的：退伍军人事务部(退伍军人事务部)保存着1970年以来所有医院出院的计算机化文件。通过利用这个大型数据库，本研究旨在确定胰腺炎是否是胰腺癌的危险因素。方法：采用多因素条件Logistic回归分析方法，对2639例胰腺癌患者和7774例正常对照组的胰腺炎发生率进行病例对照研究。结果：与胰腺炎相关的优势比从确诊前7年或以上的2.04(95%可信区间1.53~2.72)增加到确诊前3年或以上的2.14(CI，1.68~2.72)和确诊前1年或以上的2.31(CI，1.87~2.86)。在多因素分析中，所有类型的胰腺炎或单独的慢性胰腺炎与显著危险相关，其优势比分别为3.42(CI，1.98~5.91)和2.23(CI，1.43~3.49)。其他变量，如胆结石病史或酗酒史、胰腺炎出院频率和VA系统的覆盖时间均未对患者产生影响。结论：胰腺炎病史是胰腺癌后续发展的重要危险因素。随着癌症诊断前时间的缩短，风险增加可能表明一小部分胰腺癌最初被误诊为胰腺炎。
Background & Aims: The Department of Veterans Affairs (VA) maintains a computerized file of all hospital discharges since 1970. In taking advantage of this large database, the present study aimed to determine whether pancreatitis is a risk factor for pancreatic cancer. Methods: A case control study compared the occurrence of pancreatitis in 2639 patients with pancreatic cancer and a matched control group of 7774 subjects using multivariate conditional logistic regression. Results: The odds ratio associated with pancreatitis increased from 2.04 (95% confidence interval [CI], 1.53-2.72) 7 or more years before the first diagnosis of cancer to 2.14 (CI, 1.68-2.72) 3 or more years before cancer diagnosis and to 2.31 (CI, 1.87-2.86) 1 or more years before cancer diagnosis. In a multivariate analysis, all types of pancreatitis or chronic pancreatitis alone were associated with a significant risk, their odds ratios being 3.42 (CI, 1.98-5.91) and 2.23 (CI, 1.43-3.49), respectively. No influence was exerted by other variables, such as history of gallstone disease or alcoholism, frequency of hospital discharges with pancreatitis, and length of coverage in the VA system. Conclusions: A history of pancreatitis constitutes a significant risk for subsequent development of pancreatic cancer. The increase of the risk with decreasing time before the diagnosis of cancer may indicate that a fraction of pancreatic cancers are initially misdiagnosed as pancreatitis.