RISK-FACTORS FOR GALLBLADDER CANCER - A POLISH CASE-CONTROL STUDY
RISK-FACTORS FOR GALLBLADDER CANCER - A POLISH CASE-CONTROL STUDY
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DOI：
10.1002/ijc.2910510508
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发表时间：
1992-07-09
影响因子：
6.4
通讯作者：
BOYLE, P
中科院分区：
文献类型：
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作者：
ZATONSKI, WA;LAVECCHIA, C;BOYLE, P
在国际癌症研究机构 SEARCH 计划的框架内，在波兰西南部进行了一项基于人群的胆囊癌病例对照研究。共有 73 名病例和 186 名对照者接受了问卷调查，内容包括人口和社会经济因素、教育、吸烟、饮酒、茶和咖啡消费以及既往病史。经过验证的饮食史用于估计每日卡路里、脂肪、碳水化合物、蛋白质、胆固醇、纤维以及维生素 C 和 E 的摄入量。胆囊疾病是随后胆囊癌的主要决定因素。 41 例 (56%) 与 15 例 (8%) 对照者有胆囊疾病既往病史，对应的比值比 (OR) 为 12.5（95% 置信区间，5.8 至 26.6），而 20 年前或更久以前的胆囊问题的 OR 为 12.1。与教育程度呈反比关系，受教育年限为 13 年或以上的 OR 为 0.3（95% Cl 0.1 至 1.2），而受教育年数低于 7 年的 OR 为 0.3（95% Cl 0.1 至 1.2）。胆囊癌风险与总热量摄入呈正相关，与最低四分位数相比，上 3 个四分位数的 OR 为 1.4、1.5、4.1（趋势，p < 0.0 1）。蛋白质、碳水化合物和胆固醇的直接关联性较弱。有人建议，纤维摄入量呈负相关，而与维生素 C 和 E 呈负相关。这些结果进一步量化了胆结石的作用，并表明总热量摄入和其他可能与良性胆囊疾病相关的饮食因素与胆囊癌的病因有关。
A population-based case-control study of gallbladder cancer was conducted in the south-west of Poland, within the frame-work of the SEARCH Programme of the International Agency for Research on Cancer. A total of 73 cases and 186 controls were interviewed using a questionnaire including demographic and socio-economic factors, education, smoking, alcohol, tea and coffee consumption, and past medical history. A validated diet history was used to estimate the daily intake of calories, fats, carbohydrates, proteins, cholesterol, fibres and vitamins C and E. Gallbladder disease was the major determinant of subsequent gallbladder cancer. 41 cases (56%) vs. 15 (8%) controls had a past history of gallbladder disease, corresponding to an odds ratio (OR) of 12.5 (95% confidence interval, 5.8 to 26.6), and the OR was 12.1 for gallbladder problems dating back 20 years or more in the past. There was an inverse relationship with education, the OR being 0.3 (95% Cl 0.1 to 1.2) for 13 years of education or more vs. less than 7. Gallbladder cancer risk was positively associated with total calorie intake, with ORs of 1.4, 1.5, 4.1 for the 3 upper quartiles compared with the lowest one (trend, p < 0.0 1). Weaker direct associations were observed for proteins, carbohydrates and cholesterol. There was some suggestion of inverse associations with fibre intake, and a more consistent one with vitamins C and E. These results further quantify the role of gallstones, and suggest that total calorie intake and other dietary factors potentially linked with benign gallbladder conditions are involved in the aetiology of gallbladder cancer.