胆石症胆囊切除术与大肠癌关系探讨  

Cholelithiasis and cholecystectomy for colorectal cancer:a retrospective analysis

作　　者：陈瑛[1] 王祯美[1] 

机构地区：[1]北京医院消化内科

出　　处：《中华外科杂志》1998年第11期649-651,共3页Chinese Journal of Surgery

摘　　要：目的探讨胆石症胆囊切除术与大肠癌之间的发病关系。方法分析近１０年来经病理确诊的２３８例大肠癌与本院年龄性别匹配的非大肠癌３９５例进行对照研究。结果胆石症和胆囊切除术伴大肠癌与对照组比较，其相对危险性（ＯＲ）为２９５，９５％可信限１８９～４５９，χ２＝２２３１，Ｐ＜００１。胆石症与胆囊切除术例数相比为４０ｖｓ．１３（Ｐ＜００１）。６０岁以上行胆囊切除术者占６９２％（Ｐ＜００１）。女性胆石症伴结肠癌和直肠癌与男性相比，ＯＲ分别为１３７和１９９；与左结肠癌相比，发生右结肠癌的相对危险性是２１，但差异均无显著性意义。结论主要是由于胆石症，而不是胆囊切除术，增加了发生大肠癌的危险性。另外，６０岁以上的胆囊切除术患者。Objective To study the relationship between cholelithiasis and previous cholecystectomy for colorectal cancer. Method Retrospectively,the frequency of occurence of gallstones and cholecystectomy for 238 patients with colorectal cancer dignosed pathologically was compared with that of 395 matched controls for age and sex. The patients were checked by type B ultrasoungraphy or had cholelithiasis and underwent cholecystectomy. Result The relative risk(OR) of cholelithiasis and prior cholecystectomy associated with colorectal cancer was 2 95(95% confidence limits 1 89 4 59,χ 2=22 31, P <0 01).The ratio of cholelithiasis to cholecystectomy was 40 vs 13 ( P <0 01) patients.Nine of the 13 patients were over 60 years old ( P <0 01).The incidence of cholelithiasis associated with colon cancer was 36 2%(42/116),but it was only 9% (11/122) with rectal cancer ( P <0 01),and OR of choelithiasis accompanied with colon cancer and rectal cancer was 1 37 and 1 99 respectively in female male. Cholelithiasis was more common in right sided colonic cancer than in the left sided in female (OR=2 1) but there was no significant difference. Conclusion Choelithiasis other them cholecystectomy increases the risk of large bowel cancer,in addition,the relative risk of colorectal cancer is increased in patients of above 60 years old having previous cholecystectomy.

关 键 词：胆结石 胆囊切除术 大肠肿瘤 相互关系 

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