CAJ | 학술논문

目的：探讨大肠癌发病与胆囊结石之间的相关性。方法对照分析213例大肠癌患者（大肠癌组）和同期432例胃癌患者（对照组）合并胆囊结石的比率，比较大肠癌组内胆囊结石患者与非胆囊结石患者在肿瘤发生部位、性别、年龄、各影响因素分布等方面的差异。结果（1）大肠癌组合并胆囊结石41例（19.25％），对照组合并胆囊结石37例（8.56％），两组合并胆囊结石的比率比较，χ2=15.318，P=0.000，差异有高度统计学意义，大肠癌组合并胆囊结石的比率明显升高。（2）大肠癌组内，合并胆囊结石的大肠癌患者与不合并胆囊结石的患者在肿瘤解剖部位间的差异无统计学意义（χ2=5.386，P=0.068）；但在性别间的差异有高度统计学意义（χ2=11.056， P=0.001），女性大肠癌合并胆囊结石的比率明显升高；大肠癌合并胆囊结石的比率在＜50岁、50～60岁、＞60岁3个年龄段间的差异有高度统计学意义（χ2=10.557，P=0.005），＞60岁的大肠癌患者合并胆囊结石的比率明显升高；（3）多元素回归分析显示，合并胆囊结石的超重或高血压、糖尿病、肝功能异常、嗜酒、非甾体类抗炎药常规服用等因素与大肠癌发生无相关性，而伴有血脂异常（高血脂）相关（OR=2.742，95%CI：1.114～6.751，P=0.046）。结论胆囊结石可能是大肠癌发生的高危因素之一；女性胆囊结石、＞60岁的胆囊结石以及伴有血脂异常的胆囊结石并发大肠癌的风险明显升高。
목적：탐토대장암발병여담낭결석지간적상관성。방법대조분석213례대장암환자（대장암조）화동기432례위암환자（대조조）합병담낭결석적비솔，비교대장암조내담낭결석환자여비담낭결석환자재종류발생부위、성별、년령、각영향인소분포등방면적차이。결과（1）대장암조합병담낭결석41례（19.25％），대조조합병담낭결석37례（8.56％），량조합병담낭결석적비솔비교，χ2=15.318，P=0.000，차이유고도통계학의의，대장암조합병담낭결석적비솔명현승고。（2）대장암조내，합병담낭결석적대장암환자여불합병담낭결석적환자재종류해부부위간적차이무통계학의의（χ2=5.386，P=0.068）；단재성별간적차이유고도통계학의의（χ2=11.056， P=0.001），녀성대장암합병담낭결석적비솔명현승고；대장암합병담낭결석적비솔재＜50세、50～60세、＞60세3개년령단간적차이유고도통계학의의（χ2=10.557，P=0.005），＞60세적대장암환자합병담낭결석적비솔명현승고；（3）다원소회귀분석현시，합병담낭결석적초중혹고혈압、당뇨병、간공능이상、기주、비치체류항염약상규복용등인소여대장암발생무상관성，이반유혈지이상（고혈지）상관（OR=2.742，95%CI：1.114～6.751，P=0.046）。결론담낭결석가능시대장암발생적고위인소지일；녀성담낭결석、＞60세적담낭결석이급반유혈지이상적담낭결석병발대장암적풍험명현승고。
Objective To explore the correlation of colorectal cancer and gallstone. Methods The gallstone incidence of 213 cases of colorectal cancer (C group) were compared with the same period of 432 cases of gastric cancer(G group). Patients with or without gallstone were also analyzed on the difference of gender, age, location of tumor, difference of the distribution and so on. Results (1)There were 41 cases with gallstone in C group(19.2%) and 37 cases in G group(8.6%). The ratio in C group was higher than that of G,χ2=15.318, P=0.000. (2) In C group, cases with gallstone had no significant difference in the anatomic site(χ2=5.386, P=0.068). While, the gallsone ratio was higher in female cases than that of male cases(χ2=11.056, P=0.001). The gallstone ratio was significantly different among <50 years, 50-60 years,>60 years sub-groups(χ2=10.557, P=0.005), and the ratio was higher in>60 years sub-groups. (3) Multivariate regression analysis suggested that overweight or hypertension, type 2 diabetes, abnormal liver function, alcohol, non-steroidal anti-inflammatory drugs and other conventional factors were not independent risk factors for colorectal cancer. While, dyslipidemia was an independent risk factor for colorectal cancer development(OR=2.742, 95%CI:1.114-6.751, P=0.046). Conclusion Gallstone is one of the risk factors for colorectal cancer, female,>60 years patients with gallstone has significantly increased risk of colorectal cancer. Gallbladder stones patients associated with dyslipidemia (high lipids) are susceptible to colorectal cancer.