A Case-Control Assessment of Risk Factors for Gallbladder Carcinoma
A Case-Control Assessment of Risk Factors for Gallbladder Carcinoma
复制标题
胆囊癌危险因素的病例对照评估
DOI：
10.1023/a:1026675329644
复制
发表时间：
1999
影响因子：
3.1
通讯作者：
W. Lamorte
中科院分区：
文献类型：
--
作者：
T. Scott;Mitchel Carroll;F. Cogliano;Bernard F. Smith;W. Lamorte
胆囊癌是一种罕见但致命性很高的疾病。它的症状经常反映出胆石症的症状，在大多数情况下，诊断是手术中偶然发现的。虽然这种癌症的风险因素已经被提出，但实际上许多因素可能只是人口老龄化的结果。这项研究是为数不多的通过比较胆囊癌患者和胆结石人群的病例对照研究设计，结合多变量分析来确定年龄无关的危险因素来解决这一问题的研究之一。单因素分析显示胆囊癌患者比胆结石患者年龄更大，并有许多与年龄相关的疾病。根据年龄的多元回归校正，这种疾病与女性性别和既往胆结石症状史有关。癌症患者在手术时不太可能在胆囊中出现胆固醇结石。以前的吸烟史是一个很大的风险，但在统计学上意义不大。以前的研究报告说，这可能与胆囊癌患者的年龄较大有关。我们的结果显示，在用多因素分析调整年龄后，胆囊癌受试者主要是女性，更有可能报告既往的胆结石症状和吸烟。虽然胆结石通常不是从胆囊癌患者身上分离出来的，但当出现时，根据肉眼检查，它们较少被归类为胆固醇结石。针对这些人群的进一步队列研究将使我们能够就这种疾病的风险因素达成更坚实的共识。
Gallbladder carcinoma is an uncommon, but highlyfatal disease. Its symptoms frequently mirror those ofgallstone disease, and in most instances, diagnosis isan incidental finding at surgery. While risk factors have been suggested for this cancer,many may in reality simply be a consequence of the olderage of the population. This study is one of the few toapproach this question by using a case-control study design comparing gallbladder carcinomapatients with a gallstone population, coupled withmultivariate analysis to determine age-independent riskfactors. Univariate analyses showed gallbladdercarcinoma patients to be older than gallstone patientsand to have many age-associated diseases. Followingmultiple regression adjustment for age, this disease wasassociated with female gender and with a previous history of gallstone symptoms. Carcinomapatients were less likely to have cholesterol gallstonesin their gallbladders at surgery. A previous history ofsmoking was a substantial risk but of borderline statistical significance. Previous studiesreport associations that may be due to the older age ofthe gallbladder carcinoma patient. Our results show thatafter adjusting for age with multivariate analysis, gallbladder cancer subjects were predominantlyfemale, more likely to report previous gallstonesymptomology, and to smoke. While gallstones were notuniversally isolated from carcinoma patients atcholecystectomy, when present, they were less frequentlyclassified as cholesterol gallstones based on visualinspection. Further cohort studies which target thesepopulations will allow us to gain a more solid consensus on the risk factors for this disease.