Hepatitis B virus infection, diabetes mellitus, and their synergism for cholangiocarcinoma development: A case-control study in Korea
Hepatitis B virus infection, diabetes mellitus, and their synergism for cholangiocarcinoma development: A case-control study in Korea
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DOI：
10.3748/wjg.v21.i2.502
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发表时间：
2015-01-14
影响因子：
4.3
通讯作者：
Roh, Jaehoon
中科院分区：
文献类型：
--
作者：
Lee, Ban Seok;Park, Eun-Cheol;Roh, Jaehoon
目的：方法：一项基于医院的病例对照研究，我们纳入了276例胆管癌患者[193例肝外胆管癌（ECC）和83例肝内胆管癌（ICC）]，2007年至2013年期间在韩国的一家培训医院诊断，以及552例健康对照，匹配2：年龄、性别和诊断日期。胆管癌的危险因素和这些因素之间可能的协同作用分别采用条件Logistic回归和协同指数进行评估。胆管癌与B型肝炎病毒（HBV）感染、糖尿病（DM）、胆囊结石、胆总管结石和肝内胆管结石之间存在相关性，调整后的比值比（AOR）分别为4.1、2.6、1.7、12.4、12.5、1分别为39.9。HBV感染和DM之间的相加模型的协同相互作用进行了研究（AOR = 12.2; 95% CI：1.9-80.1）。在亚组分析中，胆囊结石、胆总管结石、肝胆管结石和糖尿病是ECC的显著危险因素（AOR分别为2.0、18.1、14.9和2.0），而胆总管结石、肝胆管结石、HBV感染和糖尿病是ICC的危险因素（AOR分别为8.6、157.4、5.3和4.9）。HBV感染与糖尿病之间也存在协同作用（OR = 22.7; 95%CI：2.4-214.1）。然而，有没有协同作用的其他显着的风险因素之间的相互作用胆管cancela.CONCLUSION：在韩国的这项研究中，HBV感染和糖尿病被发现发挥独立和协同作用的风险胆管癌，包括ICC。探索这种协同作用的潜在机制可能会导致高危人群胆管癌预防策略的发展。
AIM: To identify possible risk factors and their synergism for cholangiocarcinoma development.METHODS: A hospital-based, case-control study in which we included 276 cholangiocarcinoma patients [193 extrahepatic cholangiocarcinoma (ECC) and 83 intrahepatic cholangiocarcinoma (ICC)], diagnosed at a training hospital in Korea between 2007 and 2013, and 552 healthy controls matched 2: 1 for age, sex, and date of diagnosis. Risk factors for cholangiocarcinoma and possible synergism between those factors were evaluated using conditional logistic regression and synergism index, respectively.RESULTS: There was an association between cholangiocarcinoma and hepatitis B virus (HBV) infection, diabetes mellitus (DM), cholecystolithiasis, choledocholithiasis, and hepatolithiasis, with the adjusted odds ratios (AORs) of 4.1, 2.6, 1.7, 12.4, and 39.9, respectively. Synergistic interaction on the additive model was investigated between HBV infection and DM (AOR = 12.2; 95% CI: 1.9-80.1). In the subgroup analyses, cholecystolithiasis, choledocholithiasis, hepatolithiasis, and DM were significant risk factors for ECC (AOR = 2.0, 18.1, 14.9, and 2.0, respectively), whereas choledocholithiasis, hepatolithiasis, HBV infection, and DM were risk factors for ICC (AOR = 8.6, 157.4, 5.3 and 4.9, respectively). Synergistic interaction was also observed between HBV infection and DM (OR = 22.7; 95% CI: 2.4-214.1). However, there was no synergistic interaction between other significant risk factors for cholangiocarcinoma.CONCLUSION: In this Korean study, HBV infection and DM were found to exert independent and synergistic effects on the risk for cholangiocarcinoma, including ICC. Exploring the underlying mechanismsfor such synergy may lead to the development of cholangiocarcinoma prevention strategies in high-risk individuals.