胆囊癌发生相关危险因素的探讨  

Risk factors of gallbladder carcinoma

作　　者：于岚[1] 何小东[1] 武峤[1] 刘卫[1] 洪涛[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：《中华消化外科杂志》2012年第5期433-436,共4页Chinese Journal of Digestive Surgery

基　　金：北京市重点学科建设项目（HK100230446）

摘　　要：目的探索胆囊癌发生的相关危险因素，为防治胆囊癌提供理论依据。方法回顾性分析2000年1月至2010年12月北京协和医院收治的153例胆囊癌患者（胆囊癌组）的临床病理资料，并抽取同期收治的300例胆囊结石患者（胆囊结石组）和300例非胆道疾病的成年患者（对照组）作为对照进行1：2病例对照研究。计数资料采用X^2检验，对相关危险因素先进行单因素分析，采用X^2检验，筛选出有统计学意义的可疑危险因素，再用多因素Logistic回归方程进行分析。结果胆囊癌组与对照组患者比较，年龄、胆囊结石病史、绝经年龄、累积行经时间、生育与否及生育次数是胆囊癌的危险因素，差异有统计学意义（X^2=58．22，180．14，9．59，24．30，18．66，15．17，P〈0．05）；年龄、胆囊结石病史、累积行经时间及生育次数是胆囊癌的独立危险因素（X^2=55．76，180．95，24．30，8．54，P〈0．05）；进一步分析发现，有胆囊结石的患者罹患胆囊癌的危险性是无相关病史患者的34倍（OR=34．22）。绝经年龄越晚（51～55岁）、累积行经时间越长（≥30年）、生育次数较多（3次）的女性患胆囊癌的可能性越大（OR=3．96，9．68，3．51）。胆囊癌组胆囊结石患者与胆囊结石组患者比较，年龄、胆囊结石病程、累积行经时间及生育次数是胆囊癌的危险因素（×2=70．66，16．66，11．59，4．69，P〈0．05）；年龄、胆囊结石病程及累积行经时间是患胆囊癌的独立危险因素（X^2=64．29，8．82，5．58，P〈0．05）；进一步分析发现，罹患胆囊癌危险性随着年龄升高而增大，胆囊癌发生的危险性随着结石病程延长而升高。对于女性患者，累积行经时间≥30年也会增加罹患胆囊癌的危险因素。结论年龄、胆囊结石病史、胆囊结石病程、累积行经时间及生育次数可能是胆囊癌发病的危险因素。�Objective To investigate the risk factors of gallbladder carcinoma, so as to provide theoreticalbase for the prevention of gallbladder carcinoma. Methods The clinical data of 153 patients with gallbladder carcinoma （gallbladder carcinoma group） who were admitted to the Peking Union Medical College Hospital from January 2000 to December 2010 were retrospectively analyzed. A total of 300 patients with eholeeystolithiasis （cholecystolithiasis group） and 300 patients without gallbladder carcinoma or cholecystolithiasis （control group） were collected and matched at the ratio of 1：2 to conduct the controlled study. Data were statistically analyzed by the Chi-square test and conditional Logistric regression. Results Univariate analysis showed significant difference in age, history of cholecystolithiasis, postmenopausal age, accumulated menstrual period, giving birth or not and number of birth between gallbladder carcinoma group and control group （ X^2 = 58.22, 180.14, 9.59, 24.30, 18.66, 15.17, P 〈0.05）. Age, history of cholecystolithiasis, accumulated menstrual period and number of birth were the independent risk factors of gallbladder carcinoma （ X^2 = 55.76, 180.95, 24.30, 8.54, P 〈 0.05 ）. The risk of having gallbladder carcinoma in patients who had a history of choleeystolithiasis was 34 times higher than those who did not have the history of choleeystolithiasis （OR = 34.22）. Late postmenopausal age （51 -55 years old） , longer accumulated menstrual period （≥30 years）, and the number of birth （3 times） were associated with higher risk of gallbladder carcinoma （ OR = 3.96, 9.68, 3.51 ）. Age, course of cholecystolithiasis and accumulated menstrual period and number of birth were the risk factors of gallbladder carcinoma when comparing patients who have history of cholecystolithiasis in the gallbladder carcinoma group with those in the cholecystolithiasis group （X^2 =70.66, 16.66, 11.59, 4.69, P 〈0.05）. Age, course of choleeystolithiasis and accumulated menstrual pe

关 键 词：胆囊肿瘤 危险因素 

分 类 号：R735.8[医药卫生—肿瘤]