Risk factors for intrahepatic cholangiocarcinoma in a low-risk population: A nationwide case-control study
Risk factors for intrahepatic cholangiocarcinoma in a low-risk population: A nationwide case-control study
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DOI：
10.1002/ijc.22283
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发表时间：
2007-02-01
影响因子：
6.4
通讯作者：
McGlynn, Katherine A.
中科院分区：
文献类型：
--
作者：
Welzel, Tania M.;Mellemkjaer, Lene;McGlynn, Katherine A.
近年来，在一些发达国家（西方），肝内胆管癌（ICC）的发病率呈上升趋势。然而，对这些低风险人群的危险因素了解甚少。在丹麦的这项基于全国人口的病例对照研究中，我们检查了选定的医疗条件与随后的ICC风险之间的关系，以提供关于发病机制的额外线索。1978年至1991年间在丹麦诊断的所有组织学证实的ICC病例均来自丹麦癌症登记处。从中央人口登记处选择人口控制，并将其与性别和出生年份的病例进行4:1的匹配。病例和对照与丹麦医院出院登记相关联，以获取先前医院诊断的信息。比值比（OR）和95%置信区间（95% CI）采用条件逻辑回归得出。该研究共包括764例ICC病例和3056例人口控制。慢性肝病与ICC显著相关：酒精性肝病（OR = 19.22, 95% CI = 5.55-66.54），未明确肝硬化（OR = 75.9, 95% CI 10.2-565.7）。胆管疾病也与风险相关：胆管炎（OR = 6.3, 95% CI = 2.3-17.5）、胆总管结石（OR = 23.97, 95% CI = 2.9-198.9）、胆囊结石（OR = 4.0, 95% CI = 2.0-7.99），尽管胆囊切除没有改变风险（OR = 1.6, 95% CI = 0.653.7）。在其他疾病中，慢性炎症性肠病（OR = 4.7, 95% CI = 1.65-13.9）与ICC显著相关。糖尿病与ICC诊断前一年的风险相关（OR = 3.02, 95% CI = 1.05-8.69）。肥胖与风险无关。这些结果证实先前的胆管疾病增加了ICC的风险，并提示酒精性肝病和糖尿病也可能增加风险。(c) 2006 Wiley-Liss, Inc。
Recently, the incidence of intrahepatic cholangiocarcinoma (ICC) has been increasing in a number of developed (Western) countries. However, risk factors in these low-risk populations are poorly understood. In this nationwide population based case-control study in Denmark, we examined the relationship between selected medical conditions and subsequent ICC risk to provide additional clues to etiopathogenesis. All histologically confirmed ICC cases diagnosed in Denmark between 1978 and 1991 were identified from the Danish cancer registry. Population controls were selected from the central population registry and were matched 4:1 to cases on sex and year of birth. Cases and controls were linked to the Danish hospital discharge registry to obtain information on prior hospital diagnoses. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived using conditional logistic regression. A total of 764 ICC cases and 3,056 population controls were included in the study. Chronic liver diseases were significantly related to ICC: alcoholic liver disease (OR = 19.22, 95% CI = 5.55-66.54), unspecified cirrhosis (OR = 75.9, 95% CI 10.2-565.7). Bile duct diseases were also associated with risk: cholangitis (OR = 6.3, 95 % CI = 2.3-17.5), choledocholithiasis (OR = 23.97, 95 % CI = 2.9-198.9), cholecystolithiasis (OR = 4.0, 95% CI = 2.0-7.99), though gallbladder removal did not change risk (OR = 1.6, 95 % CI = 0.653.7). Among other conditions, chronic inflammatory bowel disease (OR = 4.7, 95% CI = 1.65-13.9) was significantly associated with ICC. Diabetes was associated with risk in the year prior to diagnosis of ICC (OR = 3.02, 95% CI = 1.05-8.69). Obesity was unrelated to risk. These results confirm that prior bile duct diseases increase risk of ICC and suggest that alcoholic liver disease and diabetes may also increase risk. (c) 2006 Wiley-Liss, Inc.