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目的探讨既往疾病史与胰腺癌的关系。方法采用全人群病例-对照研究,研究对象为1990年10月~1993年6月期间确诊的、年龄在35~74岁的上海市区451例胰腺癌新发病例以及按性别、年龄(5岁1组)频数配对的1552例人群对照。采用非条件logistic回归模型分析既往疾病史与胰腺癌的关系。结果男性中,糖尿病患者(OR=4.49,95%CI2.21~9.12)、慢性胰腺炎患者(OR=7.05,95%CI1.93~25.75)、胆囊切除者(OR=4.02,95%CI1.75~9.26)以及肝硬化者(OR=4.22,95%CI1.68~10.59)发生胰腺癌的危险性显著增加;女性糖尿病患者(OR=3.58,95%CI1.89~6.76)、慢性胰腺炎患者(OR=6.15,95%CI1.88~20.06)、胆囊切除者(OR=2.91,95%CI1.54~5.48)以及肝硬化者(OR=6.92,95%CI1.08~44.49)。去除胰腺癌诊断前或调查前5年内出现上述疾病史的研究对象后,男性糖尿病患者胰腺癌危险性仍显著增加(OR=3.47,95%CI1.09~11.06),其余结果虽多数危险性也升高,但均未达显著水平。结论糖尿病、慢性胰腺炎、胆囊切除以及肝硬化病史可能会增加胰腺癌的发病风险,上述疾病史可能在胰腺癌病因学中起一定的作用。
Objective To investigate the relationship between past medical history and pancreatic cancer. Methods A population-based case-control study was conducted in 451 newly diagnosed cases of pancreatic cancer in Shanghai, aged 35-74 years, diagnosed between October 1990 and June 1993, as well as age, gender, 1 group) frequency matching pairs of 1552 cases of crowd control. Non-conditional logistic regression model was used to analyze the relationship between past medical history and pancreatic cancer. Results Among the men, there was no significant difference between the patients with diabetes (OR = 4.49,95% CI 2.21-9.12), patients with chronic pancreatitis (OR = 7.05,95% CI 1.93-25.75) and cholecystectomy (OR = 4.02,95% CI1. 75 ~ 9.26) and cirrhosis (OR = 4.22, 95% CI 1.68 ~ 10.59). The risk of pancreatic cancer was significantly increased in female patients with diabetes (OR = 3.58,95% CI 1.89 ~ 6.76), chronic pancreatitis Patients (OR = 6.15, 95% CI 1.88-20.06), cholecystectomy (OR = 2.91, 95% CI 1.54-5.48) and cirrhosis (OR = 6.92, 95% CI 1.08-44.49). The risk of pancreatic cancer in male patients with diabetes was still significantly increased (OR = 3.47, 95% CI 1.09 ~ 11.06) after removing the subjects with pancreatic cancer diagnosis or within 5 years before the survey. Most of the other results were risky Increase, but did not reach the significant level. Conclusions Diabetes mellitus, chronic pancreatitis, cholecystectomy and the history of cirrhosis may increase the risk of pancreatic cancer, which may play a role in the etiology of pancreatic cancer.