CAJ | 학술논문

目的探讨肝内胆管癌(ICC)和肝外胆管癌(ECC)发生的相关危险因素.方法收集北京协和医院1998年至2008年190例胆管癌患者的临床资料,其中ICC 61例,ECC 129例,并以380名健康人作为对照组.统计所有参与者的肝脏疾病、家族病史、糖尿病、吸烟、饮酒等资料.结果 ICC患者的HBsAg(+)和anti-HBc(+)、HBsAg(-)和anti-HBc(+)、胆管结石的发生率分别为27.9%、50.8%和14.8%,ECC患者的糖尿病患病率、胆囊结石发生率、胆管结石发生率和胆囊切除率分别为18.6%、15.5%、18.6%和13.2%,均高于对照组(P＜0.05).ICC与ECC相比,ICC患者有较高的肝硬化患病率(P＜0.05).结论胆管结石、肝硬化和HBV感染是ICC发生的危险因素,而糖尿病、胆囊结石、胆管结石和胆囊切除史为ECC发生的危险因素,胆管结石是ICC和ECC发生的共同危险因素.
목적 탐토간내담관암(ICC)화간외담관암(ECC)발생적상관위험인소.방법 수집북경협화의원1998년지2008년190례담관암환자적림상자료,기중ICC 61례,ECC 129례,병이380명건강인작위대조조.통계소유삼여자적간장질병、가족병사、당뇨병、흡연、음주등자료.결과 ICC환자적HBsAg(+)화anti-HBc(+)、HBsAg(-)화anti-HBc(+)、담관결석적발생솔분별위27.9%、50.8%화14.8%,ECC환자적당뇨병환병솔、담낭결석발생솔、담관결석발생솔화담낭절제솔분별위18.6%、15.5%、18.6%화13.2%,균고우대조조(P＜0.05).ICC여ECC상비,ICC환자유교고적간경화환병솔(P＜0.05).결론 담관결석、간경화화HBV감염시ICC발생적위험인소,이당뇨병、담낭결석、담관결석화담낭절제사위ECC발생적위험인소,담관결석시ICC화ECC발생적공동위험인소.
Objective To invenstigate the risk factors of intrahepatic eholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC).Methods The clinicopathologieal data of 190 patients with eholangiocarcinomas (61 ICC and 129 ECC) diagnosed and treated in the Peking Union Medical College Hospital between 1998 and 2008 were collected.The elinieopathologieal data of 380 matched healthy controls were also collected.The information about liver diseases,family history,diabetes,smoking and drinking were recorded and analyzed.Results The positive rate of HBsAg(+) and anti-HBe(+),HBsAg(-)and anti-HBc(+) and the incidence of choledocholithiasis or hepatolithiasis in ICC patients were 27.9%,50.8% and 14.8%,respectively.The incidence of diabetes mellitus, cholecystolithiasis,choledocholithiasis or hepatolithiasis and previous eholeeystectomy in ECC patients were 18.6%,15.5%,18.6% and 13.2%,respectively.The incidences of all above mentioned factors in the ICC or ECC patients were significantly higher than that in the controls (P＜0.05 ).Compared with the patients with ECC,the ICC patients had a significantly higher cirrhosis rate (P＜0.05).Conclusion Our study results show that choledocholithiasis or hepatolithiasis,liver cirrhosis and chronic HBV infection are possible risk factors for intrahepatic cholangiocarcinoma, while choledocholithiasis or hepatolithiasis, diabetes mellitus,cholecystolithiasis,history of cholecystectomy are risk factors for extrahepatic cholangioearcinoma.