胆道结石并发肝内胆管癌风险的Meta分析  

Cholelithiasis and the risk of intrahepatic cholangiocarcinoma： a Meta-analysis

作　　者：朱征海 蔡浩[2] 顾盐炎 赵万文 胡伟东 陈超波 

机构地区：[1]无锡市锡山人民医院普外科,无锡214011 [2]复旦大学附属中山医院肝癌研究所,上海200032

出　　处：《国际外科学杂志》2015年第2期97-101,共5页International Journal of Surgery

摘　　要：目的 明确肝外胆管结石及胆囊结石并发肝内胆管癌（Intrahepatic cholangiocarcinoma,ICC）风险,为胆道结石的临床治疗提供参考.方法 计算机检索PubMed、EmBase以及CBM等数据库,查找胆道结石以及胆囊结石并发ICC风险的队列研究或者病例对照研究.应用STATA软件对所获得研究数据行Meta分析,根据研究间异质性选择固定效应模型或者随机效应模型.采用Egger检验评估发表偏倚.结果 共有6篇病例对照研究纳入分析,包括123 713例患者,其中ICC 4 753例,无瘤对照118 960例.Meta分析结果显示,胆管结石为ICC发病的高危因素（OR：17.64,95％ CI：11.14 ～27.95）,除外肝内胆管结石,肝外胆管结石导致的ICC发病风险仍较高（OR：11.79,95％ CI：4.17～ 33.35）.此外,胆囊结石也是ICC发病危险因素（OR：2.07,95％ CI：1.17 ～3.67）.结论 肝外胆管结石与胆囊结石均为ICC发病的重要危险因素.Objective To clarify the association of pre-existing choledocholithiasis or cholecystolithiasis and the development of intrahepatic cholangiocarcinoma（ICC）.Methods A computerized literature search was performed in Pubmed,EmBase and CBM.Cohort and case control studies on the risk of choledocholithiasis or cholecystolithiasis developing ICC was included.Meta-analysis was performed using STATA version 12.0.Either a fix or random effect model was used according to heterogeneity among studies.Egger＇s test was performed to assess publication bias.Results A total of 6 case control studies fulfilled our inclusion criteria including 123,713 patients,4,753 for ICC and 118,960 for tumor free controls.Bile duct stone contributed to the development of ICC （OR：15.64,95% CI 9.33-26.23）.Apart from hepatolithiasis,there was still a high risk of ICC development for choledocholithiasis （OR：11.05,95 % CI：4.02 ～ 30.37）.Cholecystolithiasis is also a risk factor for ICC （OR：2.35,95 % CI：1.28 ～ 4.31）.Conclusion Both choledocholithiasis and cholecystolithiasis are important prognostic factors for ICC.

关 键 词：肝内胆管癌 胆石 胆总管结石 胆囊结石 危险因素 

分 类 号：R195.1[医药卫生—卫生统计学]