中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2009年
12期
935-939
,共5页
周华邦%徐勤蓉%汪慧%周东勋%王昊%王庆%邹姗姗%涂芊茜%孙正勤%艾莉%吴孟超%胡和平
週華邦%徐勤蓉%汪慧%週東勛%王昊%王慶%鄒姍姍%塗芊茜%孫正勤%艾莉%吳孟超%鬍和平
주화방%서근용%왕혜%주동훈%왕호%왕경%추산산%도천천%손정근%애리%오맹초%호화평
胆管肿瘤%危险因素%病例对照研究
膽管腫瘤%危險因素%病例對照研究
담관종류%위험인소%병례대조연구
Bile duct neoplasms%Risk factors%Case-control study
目的 探讨肝内胆管细胞癌(ICC)发生的可能危险因素,为防治ICC提供理论依据.方法 对317例ICC患者和634例体检者按照年龄、性别、居住地进行1:2配比以做病例对照研究.对计数资料采用χ~2检验,计量资料采用t检验;对相关危险因素先用单因素条件Logistic回归分析方法 筛选出有统计学意义的可疑危险因素,再用多因素条件Logistic回归法进行分析.结果单因素分析显示血清HBsAg阳性、乙型肝炎相关性肝硬化、酒精性肝硬化、其他原因肝硬化、肝内胆管结石、胆总管结石以及肝血吸虫病7个因素在病例组与对照组之间差异有统计学意义(P<0.05).多因素分析证实去除了年龄、性别、居住地的影响后,血清HBsAg阳性、乙型肝炎相关性肝硬化、酒精性肝硬化、其他原因肝硬化,肝内胆管结石以及肝血吸虫病仍与ICC显著相关,其比值比(95%可信区间)分别为10.265(6.676~15.783),13.101(5.265~32.604),18.242(3.580~92.958)、18.435(1.930~176.082),15.102(4.607~49.499)和11.820(3.522~39.668).胆总管结石在单因素分析中有统计学意义,但在多因素分析中P值未达到有统计学意义的水平(P>0.05).肝囊肿、胆囊结石、肝血管瘤、脂肪性肝炎、糖尿病、吸烟、饮酒在病例组与对照组之间差异无统计学意义(P>0.05).结论 HBV感染、肝硬化尤其是乙型肝炎相关性肝硬化、肝内胆管结石病以及肝血吸虫病可能是ICC发病的危险因素.其中,值得关注的是,国内的ICC患者,HBV感染率明显高于目前其他国家的文献报道,HBV感染及其引起的肝硬化可能是国内ICC发生最重要的危险因素.
目的 探討肝內膽管細胞癌(ICC)髮生的可能危險因素,為防治ICC提供理論依據.方法 對317例ICC患者和634例體檢者按照年齡、性彆、居住地進行1:2配比以做病例對照研究.對計數資料採用χ~2檢驗,計量資料採用t檢驗;對相關危險因素先用單因素條件Logistic迴歸分析方法 篩選齣有統計學意義的可疑危險因素,再用多因素條件Logistic迴歸法進行分析.結果單因素分析顯示血清HBsAg暘性、乙型肝炎相關性肝硬化、酒精性肝硬化、其他原因肝硬化、肝內膽管結石、膽總管結石以及肝血吸蟲病7箇因素在病例組與對照組之間差異有統計學意義(P<0.05).多因素分析證實去除瞭年齡、性彆、居住地的影響後,血清HBsAg暘性、乙型肝炎相關性肝硬化、酒精性肝硬化、其他原因肝硬化,肝內膽管結石以及肝血吸蟲病仍與ICC顯著相關,其比值比(95%可信區間)分彆為10.265(6.676~15.783),13.101(5.265~32.604),18.242(3.580~92.958)、18.435(1.930~176.082),15.102(4.607~49.499)和11.820(3.522~39.668).膽總管結石在單因素分析中有統計學意義,但在多因素分析中P值未達到有統計學意義的水平(P>0.05).肝囊腫、膽囊結石、肝血管瘤、脂肪性肝炎、糖尿病、吸煙、飲酒在病例組與對照組之間差異無統計學意義(P>0.05).結論 HBV感染、肝硬化尤其是乙型肝炎相關性肝硬化、肝內膽管結石病以及肝血吸蟲病可能是ICC髮病的危險因素.其中,值得關註的是,國內的ICC患者,HBV感染率明顯高于目前其他國傢的文獻報道,HBV感染及其引起的肝硬化可能是國內ICC髮生最重要的危險因素.
목적 탐토간내담관세포암(ICC)발생적가능위험인소,위방치ICC제공이론의거.방법 대317례ICC환자화634례체검자안조년령、성별、거주지진행1:2배비이주병례대조연구.대계수자료채용χ~2검험,계량자료채용t검험;대상관위험인소선용단인소조건Logistic회귀분석방법 사선출유통계학의의적가의위험인소,재용다인소조건Logistic회귀법진행분석.결과단인소분석현시혈청HBsAg양성、을형간염상관성간경화、주정성간경화、기타원인간경화、간내담관결석、담총관결석이급간혈흡충병7개인소재병례조여대조조지간차이유통계학의의(P<0.05).다인소분석증실거제료년령、성별、거주지적영향후,혈청HBsAg양성、을형간염상관성간경화、주정성간경화、기타원인간경화,간내담관결석이급간혈흡충병잉여ICC현저상관,기비치비(95%가신구간)분별위10.265(6.676~15.783),13.101(5.265~32.604),18.242(3.580~92.958)、18.435(1.930~176.082),15.102(4.607~49.499)화11.820(3.522~39.668).담총관결석재단인소분석중유통계학의의,단재다인소분석중P치미체도유통계학의의적수평(P>0.05).간낭종、담낭결석、간혈관류、지방성간염、당뇨병、흡연、음주재병례조여대조조지간차이무통계학의의(P>0.05).결론 HBV감염、간경화우기시을형간염상관성간경화、간내담관결석병이급간혈흡충병가능시ICC발병적위험인소.기중,치득관주적시,국내적ICC환자,HBV감염솔명현고우목전기타국가적문헌보도,HBV감염급기인기적간경화가능시국내ICC발생최중요적위험인소.
Objective To explore the potential risk factors of intrabepatic cholangiocarcinoma(ICe)in China.Method A case-control study including 317 patients with pathologically confirmed ICC and 634healthy individuals was conducted.The cases and controls were matched in age.sex and inhabitancy.Data were statistically analyzed by Chi-square test and conditional logistic regression.Results Univariate analysis showed significant difference in HBsAg seropositivity,liver cirrhosis,hepatolithiasis,choledocholithiasis and schistosomiasis between ICC patients and healthy controls(P<0.05).Multivariate analysis confirmed that HBsAg seropositivity,liver cirrhosis,hepatolithiasis and hepatic schistosomiasis were associated with ICC,and their adjusted odds ratio(95%confidence interval)were 10.265(6.676-15.783),13.101(5.265-32.604),18.242(3.580-92.958),18.435(1.930-176.082),15.102(4.607-49.499)and 11.820(3.522-39.668),respectively.The incidence of hepatic cyst,cholecystolithiasis,hepatic hemangioma,fatty liver, diabetes mellitus,smoking and drinking were not significantly different between ICC patients and controls.Conclusions The HBV infection,liver cirrhosis,hepatolithiasis and hepatic schistosomiasis may be the risk factors for ICC in China.