Gallstones and the risk of biliary tract cancer: a population-based study in China.
Gallstones and the risk of biliary tract cancer: a population-based study in China.
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DOI：
10.1038/sj.bjc.6604047
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发表时间：
2007-12-03
影响因子：
8.8
通讯作者：
Fraumeni, J. F., Jr.
中科院分区：
文献类型：
--
作者：
Hsing, A. W.;Gao, Y-T;Han, T-Q;Rashid, A.;Sakoda, L. C.;Wang, B-S;Shen, M-C;Zhang, B-H;Niwa, S.;Chen, J.;Fraumeni, J. F., Jr.
我们对627例胆道癌患者（368例胆囊癌，191例胆管癌和68例乏特壶腹癌），1037例胆结石患者和959名健康对照者进行了一项基于人群的研究，所有人都接受了个人采访。胆结石状态是基于自我报告、影像学检查、手术记录和医疗记录的信息。在对照组中，进行经腹超声检查以检测无症状的胆结石。从癌症病例和胆结石患者中取出的胆结石根据大小、重量、颜色、图案和胆固醇、胆红素和胆汁酸的含量进行分类。在癌症患者中，69%的人患有胆结石，而对照组的这一比例为23%。与无胆结石的受试者相比，与胆结石相关的比值比为23.8（95%置信区间（CI），17.0-33.4），8.0（95% CI 5.6-11.4）和4.2（95% CI 2.5-7.0）分别为胆囊癌、肝外胆管癌和乏特壶腹癌，仅限于癌症前至少10年的胆结石患者。胆结石和自我报告的胆囊炎受试者中的胆道癌风险较高，尤其是胆囊癌（OR=34.3，95%CI 19.9-59.2）。胆色素结石和胆固醇结石的发生率分别为胆管癌和胆囊癌（P<0.001）。胆囊癌患者的胆囊结石重量显著高于胆囊结石患者（4.9 vs 2.8 g; P=0.001）。我们估计，在上海，胆囊癌、胆管癌和壶腹癌分别有80%（95%CI 75-84%）、59%（56-61%）和41%（29-59%）可归因于胆结石。
We conducted a population-based study of 627 patients with biliary tract cancers (368 of gallbladder, 191 bile duct, and 68 ampulla of Vater), 1037 with biliary stones, and 959 healthy controls randomly selected from the Shanghai population, all personally interviewed. Gallstone status was based on information from self-reports, imaging procedures, surgical notes, and medical records. Among controls, a transabdominal ultrasound was performed to detect asymptomatic gallstones. Gallstones removed from cancer cases and gallstone patients were classified by size, weight, colour, pattern, and content of cholesterol, bilirubin, and bile acids. Of the cancer patients, 69% had gallstones compared with 23% of the population controls. Compared with subjects without gallstones, odds ratios associated with gallstones were 23.8 (95% confidence interval (CI), 17.0–33.4), 8.0 (95% CI 5.6–11.4), and 4.2 (95% CI 2.5–7.0) for cancers of the gallbladder, extrahepatic bile ducts, and ampulla of Vater, respectively, persisting when restricted to those with gallstones at least 10 years prior to cancer. Biliary cancer risks were higher among subjects with both gallstones and self-reported cholecystitis, particularly for gallbladder cancer (OR=34.3, 95% CI 19.9–59.2). Subjects with bile duct cancer were more likely to have pigment stones, and with gallbladder cancer to have cholesterol stones (P<0.001). Gallstone weight in gallbladder cancer was significantly higher than in gallstone patients (4.9 vs 2.8 grams; P=0.001). We estimate that in Shanghai 80% (95% CI 75–84%), 59% (56–61%), and 41% (29–59%) of gallbladder, bile duct, and ampulla of Vater cancers, respectively, could be attributed to gallstones.
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影响因子：
3.1
作者：
Swidsinski, A;Lee, SP
通讯作者：
Lee, SP
影响因子：
4.7
作者：
Sakoda, Lori C.;Gao, Yu-Tang;Hsing, Ann W.
通讯作者：
Hsing, Ann W.
影响因子：
4.7
作者：
Matsuba T;Qiu D;Kurosawa M;Lin Y;Inaba Y;Kikuchi S;Yagyu K;Motohashi Y;Tamakoshi A;JACC Study Group
通讯作者：
JACC Study Group
影响因子：
120.7
作者：
DIEHL, AK
通讯作者：
DIEHL, AK
影响因子：
10.3
作者：
Zatonski, WA;Lowenfels, AB;Walker, AM
通讯作者：
Walker, AM