中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
1期
52-55
,共4页
朱军民%张有成%陈睿%牛鸣%郑燕%王经韬%孟晓燕%陈定军%张云%马继林%姚为贵%崔小林%李兵兵
硃軍民%張有成%陳睿%牛鳴%鄭燕%王經韜%孟曉燕%陳定軍%張雲%馬繼林%姚為貴%崔小林%李兵兵
주군민%장유성%진예%우명%정연%왕경도%맹효연%진정군%장운%마계림%요위귀%최소림%리병병
胆囊结石病%胆囊切除术%结直肠肿瘤%队列研究
膽囊結石病%膽囊切除術%結直腸腫瘤%隊列研究
담낭결석병%담낭절제술%결직장종류%대렬연구
Cholecystolithiasis%Cholecystectomy%Colorectal neoplasms%Cohort studies
目的 探讨胆囊结石及胆囊切除与大肠癌之间的关系.方法 应用回顾性队列研究方法分析2000-2007年5573例胆囊结石和8187例非胆囊结石患者的资料,分为胆囊结石组(胆囊切除亚组、胆囊不切除亚组)和对照组；比较两组间、两亚组间大肠癌累积发病率以及胆囊结石组内大肠癌发病与性别、年龄、结石病程、大肠癌肿瘤部位、超重、高血压病、糖尿病、血脂、肝功能等因素的相关性.结果(1)大肠癌累积发病率胆囊结石组为0.43％(24/5573),对照组为0.13％(11/8187),两组比较,差异有统计学意义(x2=11.879,P=0.001).(2)大肠癌累积发病率胆囊结石组胆囊切除亚组为0.45％(17/3809),胆囊不切除亚组为0.40％(7/1764),两亚组间差异无统计学意义(x2 =0.069,P=0.793).(3)胆囊结石病程＜15年时大肠癌累积发病率为0.23％(8/3467),≥15年时为0.76％(16/2106),差异有统计学意义(x2=8.550,P=0.003).(4)伴有血清甘油三酯水平升高者,在胆囊结石组大肠癌病例中占20.83％(5/24),非大肠癌病例中占5.86％(325/5549),差异有统计学意义(x2 =9.621,P=0.002).(5)胆囊结石组大肠癌发病风险与性别、年龄、超重、高血压病、糖尿病、肝功能异常等因素无相关性(x2 =1.444,P=0.229;x2 =7.833,P=0.251;x2=1.151,P=0.283；x2=0.797,P=0.372；x2=0.939,P=0.332；x2=2.103,P=0.147).(6)胆囊结石组发生的大肠癌中直肠癌和右半结肠癌,分别占41％(10/24)、38％(9/24),左半结肠癌和多发性癌分别占17％(4/24)和4％(1/24).结论 胆囊结石症可能是大肠癌发生的高危因素之一；病程≥15年或血脂升高的胆囊结石患者,发生大肠癌的危险性增加；与胆囊结石症有相关性的大肠癌以直肠癌和右半结肠癌较多.
目的 探討膽囊結石及膽囊切除與大腸癌之間的關繫.方法 應用迴顧性隊列研究方法分析2000-2007年5573例膽囊結石和8187例非膽囊結石患者的資料,分為膽囊結石組(膽囊切除亞組、膽囊不切除亞組)和對照組；比較兩組間、兩亞組間大腸癌纍積髮病率以及膽囊結石組內大腸癌髮病與性彆、年齡、結石病程、大腸癌腫瘤部位、超重、高血壓病、糖尿病、血脂、肝功能等因素的相關性.結果(1)大腸癌纍積髮病率膽囊結石組為0.43％(24/5573),對照組為0.13％(11/8187),兩組比較,差異有統計學意義(x2=11.879,P=0.001).(2)大腸癌纍積髮病率膽囊結石組膽囊切除亞組為0.45％(17/3809),膽囊不切除亞組為0.40％(7/1764),兩亞組間差異無統計學意義(x2 =0.069,P=0.793).(3)膽囊結石病程＜15年時大腸癌纍積髮病率為0.23％(8/3467),≥15年時為0.76％(16/2106),差異有統計學意義(x2=8.550,P=0.003).(4)伴有血清甘油三酯水平升高者,在膽囊結石組大腸癌病例中佔20.83％(5/24),非大腸癌病例中佔5.86％(325/5549),差異有統計學意義(x2 =9.621,P=0.002).(5)膽囊結石組大腸癌髮病風險與性彆、年齡、超重、高血壓病、糖尿病、肝功能異常等因素無相關性(x2 =1.444,P=0.229;x2 =7.833,P=0.251;x2=1.151,P=0.283；x2=0.797,P=0.372；x2=0.939,P=0.332；x2=2.103,P=0.147).(6)膽囊結石組髮生的大腸癌中直腸癌和右半結腸癌,分彆佔41％(10/24)、38％(9/24),左半結腸癌和多髮性癌分彆佔17％(4/24)和4％(1/24).結論 膽囊結石癥可能是大腸癌髮生的高危因素之一；病程≥15年或血脂升高的膽囊結石患者,髮生大腸癌的危險性增加；與膽囊結石癥有相關性的大腸癌以直腸癌和右半結腸癌較多.
목적 탐토담낭결석급담낭절제여대장암지간적관계.방법 응용회고성대렬연구방법분석2000-2007년5573례담낭결석화8187례비담낭결석환자적자료,분위담낭결석조(담낭절제아조、담낭불절제아조)화대조조；비교량조간、량아조간대장암루적발병솔이급담낭결석조내대장암발병여성별、년령、결석병정、대장암종류부위、초중、고혈압병、당뇨병、혈지、간공능등인소적상관성.결과(1)대장암루적발병솔담낭결석조위0.43％(24/5573),대조조위0.13％(11/8187),량조비교,차이유통계학의의(x2=11.879,P=0.001).(2)대장암루적발병솔담낭결석조담낭절제아조위0.45％(17/3809),담낭불절제아조위0.40％(7/1764),량아조간차이무통계학의의(x2 =0.069,P=0.793).(3)담낭결석병정＜15년시대장암루적발병솔위0.23％(8/3467),≥15년시위0.76％(16/2106),차이유통계학의의(x2=8.550,P=0.003).(4)반유혈청감유삼지수평승고자,재담낭결석조대장암병례중점20.83％(5/24),비대장암병례중점5.86％(325/5549),차이유통계학의의(x2 =9.621,P=0.002).(5)담낭결석조대장암발병풍험여성별、년령、초중、고혈압병、당뇨병、간공능이상등인소무상관성(x2 =1.444,P=0.229;x2 =7.833,P=0.251;x2=1.151,P=0.283；x2=0.797,P=0.372；x2=0.939,P=0.332；x2=2.103,P=0.147).(6)담낭결석조발생적대장암중직장암화우반결장암,분별점41％(10/24)、38％(9/24),좌반결장암화다발성암분별점17％(4/24)화4％(1/24).결론 담낭결석증가능시대장암발생적고위인소지일；병정≥15년혹혈지승고적담낭결석환자,발생대장암적위험성증가；여담낭결석증유상관성적대장암이직장암화우반결장암교다.
Objective To determine the association of gallstone,cholecystectomy and colorectal cancer.Methods From 2000 through 2007,a historical cohort study was carried out in the check analysis of the cumulative incidence of colorectal cancer of 3809 gallstone patients who had had cholecystectomies (cholecystectomy sub-group),1764 gallstone patients who had not had cholecystectomies(noncholecystectomy sub-group)and 8187 nongallstone patients(control group)were also included in the analysis of the incidence of colorectal cancer.Results(1)The cumulative incidence of colorectal cancer of the gall-stone group was 0.43 ％(24/5573)while that of the control group was 0.13 ％(11/8187)(x2 =11.879,P =0.001).(2)The cumulative incidence of colorectal cancer in cholecystectomy sub-group was 0.45％(17/3890)while that of the non-cholecystectomy sub-group was 0.40％(7/1764)(x2=0.069,P =0.793).(3)The cumulative incidence of colorectal cancer was 0.23％(8/3467)in gallstone patients with a conrse ＜ 15 years,while that was 0.76％(16/2106)when the course ≥ 15 years(x2 =8.550,P =0.003).(4)Serum triglyceride level elevated in 20.83％(5/24)colorectal cancer cases of gallstone group,however serum triglyceride level elevated only in 5.86％(325/5549)of gallstone group with non-colorectal cancer cases(x2 =9.621,P =0.002).(5)The incidence of colorectal cancer in gallstone group was not related to gender,age,overweight,hypertension,diabetes mellitus and dysfunction of liver(x2 =1.444,P =0.229;x2=7.833,P=0.251;x2 =1.151,P=0.283;x2 =0.797,P=0.372;x2 =0.939,P=0.332;x2 =2.103,P =0.147).(6)The ratio of rectal cancer,right colonic cancer,left colonic cancer and multifocal carcinoma were 41％(10/24),38％(9/24),17％(4/24)and4％(1/24),respectively.Conclusions Gallstone is a high risk factor of colorectal cancer irrespective of whether or not a cholecystectomy is carried out.Over fifteen-years course of gallstone and hypertriglyceridemia significantly increases the risk of the colorectal cancer in gallstone patients.The incidence of rectal cancer and right colonic cancer is more frequently seen in gallstone related colorectal cancer.
