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目的 研究分析既往疾病史和胆道癌 (包括胆囊癌、肝外胆管癌和壶腹部癌 )的关系。方法 自 1997年 6月～ 2 0 0 1年 5月 ,在上海市区开展了一项大规模的基于全人群的胆道癌的病例对照研究 ,共收集、调查了 6 6 4例胆道癌新病例和 894例人群对照。结果 研究发现既往有胆囊炎疾病史者患胆囊癌、肝外胆管癌的危险性升高 ,调整的比数比分别为 2 .2 (95 %CI =1.3～ 3.6 )和 1.9(95 %CI=1.0～ 3.3)。糖尿病患者患胆囊癌的危险性增加 ,调整的比数比为 1.5 (95 %CI=0 .9～ 2 .5 ) ,在非胆结石者中调整的比数比为 2 .0 (95 %CI=0 .9～ 4 .5 ) ;此外 ,研究还发现肝硬化者患肝外胆管癌的危险性明显增加 ,调整的比数比为 3.0 (95 %CI=1.0～ 9.1) ,在非胆结石者中调整的比数比为 4 .9(95 %CI=1.2～ 19.8)。结论 该项研究为论证胆囊炎症增加患胆道癌的危险性提供了依据 ,研究还提示糖尿病和肝硬化分别提高患胆囊癌和肝外胆管癌的危险性。
Objective To study the relationship between previous disease history and biliary tract cancer (including gallbladder cancer, extrahepatic bile duct cancer, and ampullary carcinoma). Methods From June 1997 to May 2001, a large case-control study of biliary tract cancer was conducted in Shanghai. A total of 664 new cases of biliary tract cancer were collected and investigated. Compared with 894 people. RESULTS: The study found that patients with previous history of cholecystitis had an increased risk of gallbladder cancer and extrahepatic cholangiocarcinoma. The adjusted odds ratios were 2.2 (95% CI = 1.3 to 3.6) and 1.9 (95% CI), respectively. 1.0 to 3.3). Diabetes patients had an increased risk of gallbladder cancer, with an adjusted odds ratio of 1.5 (95% CI=0.9% to 2.5) and an adjusted odds ratio of 2.0 (95% CI) in non-gallstone individuals. =0.9-4. 5 ); In addition, the study also found that the risk of extrahepatic cholangiocarcinoma was significantly increased in cirrhotic patients, and the adjusted odds ratio was 3.0 (95% CI=1.0 to 9.1) in non-choledole The adjusted odds ratio was 4.9 (95% CI = 1.2 to 19.8). Conclusions This study provides a basis for demonstrating that gallbladder inflammation increases the risk of biliary tract cancer. The study also suggests that both diabetes and cirrhosis increase the risk of gallbladder cancer and extrahepatic cholangiocarcinoma, respectively.