胆石症与肝、胆道和胰腺癌症风险：两项美国队列内的前瞻性研究。
Gallstones and risk of cancers of the liver, biliary tract and pancreas: a prospective study within two U.S. cohorts.
机构信息
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning, P. R. China.
出版信息
Br J Cancer. 2022 Oct;127(6):1069-1075. doi: 10.1038/s41416-022-01877-5. Epub 2022 Jun 17.
BACKGROUND
Gallstones may result in inflammation, altered bile flow, and changes in metabolic hormone levels, thereby increasing cancer risk. However, previous studies for gallstones and cancers of the liver, biliary tract and pancreas in the U.S. were relatively limited.
METHODS
We followed 115,036 women from the Nurses' Health Study (1982-2012) and 49,729 men from the Health Professionals Follow-up Study (1986-2012). History of gallstones, including with or without performed cholecystectomy, was reported at baseline and updated through biennial questionnaires. The Cox proportional hazard regression model was used to calculate multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs).
RESULTS
During up to 30-year follow-up, we identified 204 incidents of liver cancer, 225 biliary tract cancer and 1147 pancreatic cancer cases. Compared to those without gallstones diagnosis, the multivariable HRs for individuals with gallstones (untreated or with cholecystectomy) were 1.60 for liver cancer (95% CI: 1.14-2.26), 4.79 for biliary tract cancer (95% CI: 3.02-7.58), and 1.13 for pancreatic cancer (95% CI: 0.96-1.32). The multivariable HRs for individuals with cholecystectomy were 1.33 for liver cancer (95% CI: 0.90-1.95) and 1.15 for pancreatic cancer (95% CI: 0.98-1.36).
CONCLUSIONS
Gallstones were associated with a higher risk of cancers of the liver, biliary tract and possibly pancreas.
背景
胆结石可能导致炎症、胆汁流动改变和代谢激素水平变化，从而增加癌症风险。然而，之前在美国进行的胆结石与肝癌、胆道癌和胰腺癌的研究相对有限。
方法
我们随访了 115036 名来自护士健康研究（1982-2012 年）的女性和 49729 名来自健康专业人员随访研究（1986-2012 年）的男性。基线时报告了胆结石病史，包括有无胆囊切除术，并通过每两年一次的问卷进行更新。使用 Cox 比例风险回归模型计算多变量风险比（HRs）和 95%置信区间（95%CI）。
结果
在长达 30 年的随访期间，我们发现了 204 例肝癌、225 例胆道癌和 1147 例胰腺癌病例。与没有胆结石诊断的人相比，有胆结石（未经治疗或接受胆囊切除术）的个体的肝癌多变量 HR 为 1.60（95%CI：1.14-2.26），胆道癌为 4.79（95%CI：3.02-7.58），胰腺癌为 1.13（95%CI：0.96-1.32）。接受胆囊切除术的个体的肝癌多变量 HR 为 1.33（95%CI：0.90-1.95），胰腺癌为 1.15（95%CI：0.98-1.36）。
结论
胆结石与肝癌、胆道癌和可能的胰腺癌风险增加相关。
Zotero 插件