胆管癌发生的相关危险因素病例对照研究  

Case-control study of risk factors in cholangiocarcinoma

作　　者：陶连元[1] 何小东[1] 蔡磊[1] 刘卫[1] 纪文娟[1] 赵磊[1] 张双民[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院基本外科,100730

出　　处：《中华肿瘤杂志》2009年第10期759-763,共5页Chinese Journal of Oncology

基　　金：北京市重点学科资助项目（HK100230446）

摘　　要：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ICC61例，ECC129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。Objective To invenstigate the risk factors of intrahepatic cholangiocarcinoma （ICC） and extrahepatic cholangiocarcinoma （ECC）. Methods The clinicopathological data of 190 patients with cholangiocarcinomas （61 ICC and 129 ECC） diagnosed and treated in the Peking Union Medical College Hospital between 1998 and 2008 were collected. The clinicopathological 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-HBc（ ＋ ）, HBsAg（ - ） and anti-HBc（ ＋ ） and the incidence of choledoeholithiasis 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 cholecystectomy 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 cholangiocarcinoma.

关 键 词：胆管癌 肝炎病毒 危险因素 

分 类 号：R686[医药卫生—骨科学]