CHOLECYSTECTOMY AND SUBSITE-SPECIFIC LARGE BOWEL CANCER

建议进行一项流行病学病例对照研究，以确定 胆囊切除术是右侧结肠癌的危险因素，左侧 结肠癌，或直肠癌。这项研究将在 伊利诺伊州癌症委员会，旨在允许对此进行调查 男性、女性和特定年龄亚组之间的关系以及 自胆囊切除后暴露的持续时间。三个病例组中的每一个 将与由配偶组成的单一对照序列进行比较 确认身份的病人。将与男性病例进行比较 女性病例和女性病例的配偶与男性的配偶 案子。所有人的胃肠道手术史都将被确定。 研究对象的存在或不存在的历史 可以注意到胆囊切除术。将获得胆囊切除史 通过电话采访，随后从操作员和 手术时的病理报告。胆囊癌的切除史 大肠癌患者也将从医院记录中提取出来 在癌症诊断时，将尝试确认状态 通过口腔或超声检查的手术报告 胆囊造影术和体检。如果这件事的结果 调查是积极的，一项涉及多个中心的更大规模的研究 建议研究胆汁酸酯酶的作用，并与 不行胆囊切除术的亚特征性大肠病变的风险 癌症。此外，一项临床横断面研究涉及大型 肠癌患者和对照组，无论是否接受胆囊切除术，都可能 被证明是正当的。这样的研究将包括粪便诱变剂、粪便 胆汁酸和胆固醇代谢产物和肠道细菌，以及 亚位点特异性大肠上皮的突变检测。这个 胆汁代谢与大肠癌的关系尚不清楚。 因此，结果来自电流和势能，随后 调查可能会增加对这种关系的理解。因此， 关于结肠癌病因的知识可能会增加。

An epidemiologic case-control study is proposed to determine if cholecystectomy is a risk factor for right-side colon cancer, left-side colon cancer, or rectal cancer. The study, which will be conducted at the Illinois Cancer Council, is designed to allow investigation of this relationship among males, females, and age-specific subgroups and by duration of exposure since cholecystectomy. Each of the three case groups will be compared to a single control series consisting of the spouses of the identified patients. Comparisons will be made of male cases with the spouses of the female cases and female cases with the spouses of the male cases. The gastrointestinal surgical history will be ascertained for all study subjects so that the presence or absence of a history of cholecystectomy can be noted. Cholecystectomy history will be obtained through telephone interviews and subsequently validated from operative and pathology reports at time of this surgery. Cholecystectomy history for the large bowel cancer patients will also be abstracted from hospital records at time of cancer diagnosis and attempts will be made to confirm the status of the gallblader through operative reports, oral or ultrasonic cholecystography and physical examinations. If the results of this investigation are positive, a larger study involving multiple centers is sugested to investigate the effects of gallbladder diesase, with and without cholecystectomy, on the risk for subsite-specific large bowel cancer. In addition, a clinical cross-sectional study involving large bowel cancer patients and controls, with and without cholecystectomy, might be justified. Such a study would include assays of fecal mutagens, fecal bile acid and cholesterol metabolites and intestinal bacteria, as well as mutagenic testing of subsite-specific large bowel epithelium. The relationship between biliary metabolism and large bowel cancer is unclear, and therefore the results from the current and potential, subsequent investigations may increase the understanding of this relationship. Thus, knowledge of the etiology of large bowel cancer may be increased.