CAJ | 학술논문

目的明确肝外胆管结石及胆囊结石并发肝内胆管癌(Intrahepatic cholangiocarcinoma,ICC)风险,为胆道结石的临床治疗提供参考.方法计算机检索PubMed、EmBase以及CBM等数据库,查找胆道结石以及胆囊结石并发ICC风险的队列研究或者病例对照研究.应用STATA软件对所获得研究数据行Meta分析,根据研究间异质性选择固定效应模型或者随机效应模型.采用Egger检验评估发表偏倚.结果共有6篇病例对照研究纳入分析,包括123 713例患者,其中ICC 4 753例,无瘤对照118 960例.Meta分析结果显示,胆管结石为ICC发病的高危因素(OR:17.64,95％ CI:11.14 ～27.95),除外肝内胆管结石,肝外胆管结石导致的ICC发病风险仍较高(OR:11.79,95％ CI:4.17～ 33.35).此外,胆囊结石也是ICC发病危险因素(OR:2.07,95％ CI:1.17 ～3.67).结论肝外胆管结石与胆囊结石均为ICC发病的重要危险因素.
목적 명학간외담관결석급담낭결석병발간내담관암(Intrahepatic cholangiocarcinoma,ICC)풍험,위담도결석적림상치료제공삼고.방법 계산궤검색PubMed、EmBase이급CBM등수거고,사조담도결석이급담낭결석병발ICC풍험적대렬연구혹자병례대조연구.응용STATA연건대소획득연구수거행Meta분석,근거연구간이질성선택고정효응모형혹자수궤효응모형.채용Egger검험평고발표편의.결과 공유6편병례대조연구납입분석,포괄123 713례환자,기중ICC 4 753례,무류대조118 960례.Meta분석결과현시,담관결석위ICC발병적고위인소(OR:17.64,95％ CI:11.14 ～27.95),제외간내담관결석,간외담관결석도치적ICC발병풍험잉교고(OR:11.79,95％ CI:4.17～ 33.35).차외,담낭결석야시ICC발병위험인소(OR:2.07,95％ CI:1.17 ～3.67).결론 간외담관결석여담낭결석균위ICC발병적중요위험인소.
Objective To clarify the association of pre-existing choledocholithiasis or cholecystolithiasis and the development of intrahepatic cholangiocarcinoma(ICC).Methods A computerized literature search was performed in Pubmed,EmBase and CBM.Cohort and case control studies on the risk of choledocholithiasis or cholecystolithiasis developing ICC was included.Meta-analysis was performed using STATA version 12.0.Either a fix or random effect model was used according to heterogeneity among studies.Egger's test was performed to assess publication bias.Results A total of 6 case control studies fulfilled our inclusion criteria including 123,713 patients,4,753 for ICC and 118,960 for tumor free controls.Bile duct stone contributed to the development of ICC (OR:15.64,95％ CI 9.33-26.23).Apart from hepatolithiasis,there was still a high risk of ICC development for choledocholithiasis (OR:11.05,95 ％ CI:4.02 ～ 30.37).Cholecystolithiasis is also a risk factor for ICC (OR:2.35,95 ％ CI:1.28 ～ 4.31).Conclusion Both choledocholithiasis and cholecystolithiasis are important prognostic factors for ICC.