胆囊疾病与大肠癌发生的关联性分析  

Clinic study on the association between gallbladder diseases and colorectal cancer

作　　者：张梦[1] 孟涛[1] 成芳[1] 刘莹[1] 

机构地区：[1]新疆医科大学附属肿瘤医院特需科,新疆乌鲁木齐830011

出　　处：《中华肿瘤防治杂志》2016年第4期258-261,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的在大肠癌患者中，发现伴有胆囊结石及胆囊切除（简称胆囊疾病）的现象较常见。本研究旨在探讨胆囊疾病与大肠癌发生之间的关系。方法回顾性收集2010—0101—2014-12—31新疆医科大学附属肿瘤医院收治的1514例大肠癌患者的资料作为大肠癌组；健康对照组是从同一时期在新疆医科大学附属肿瘤医院体检中心进行体检的健康人群中选取，采用系统抽样的方法，随机抽取1523例健康人群作为健康对照。两组资料进行回顾性分析，观察两组合并胆囊疾病的发生情况，以及大肠癌组中，有胆囊疾病的患者与无胆囊疾病患者在年龄、性别、民族、糖尿病、甘油三酯、吸烟、饮酒、体质指数（bodymassindex，BMI）和肿瘤发生部位等各因素之间的差异。结果1）大肠癌组合并胆囊结石及胆囊切除的病例分别为81例（30．2％）和187例（69．8％）；健康对照组合并胆囊结石及胆囊切除的病例分别为44例（40．0％）和66例（60．0％），两组相比，差异有统计学意义（x2=52．239，P〈0．001；x2=22．747，P〈0．001）。2）多因素分析显示，伴有胆囊疾病的合并有甘油三酯异常（x2=4．205，P=0．040）、糖尿病（x2=10．807，P=0．001）、年龄≥60岁（x2=4．954，P=0．026）等因素是大肠癌发生的独立危险因素，且以右半大肠癌为高发（x2=24．634，P=0．000），但与性别（x2=0．591，P=0．442）、民族（x2=0．027，P=0．870）、BMI（x2=3．550，P=0．060）、吸烟（x2=0．912，P=0．339）、饮酒（x2=1．781，P=0．182）等因素无关。结论大肠癌患者患有胆囊结石及胆囊切除的概率较健康组高，胆囊结石及胆囊切除可能是大肠癌发生的高危因素，尤其是右半结肠癌的发生；≥60岁、伴有糖尿病以及甘油三酯异常且合并胆囊疾病者发生大肠癌的风险明显升高。OBJECTIVE It was a common phenomenon that in colorectal cancer accompanied by the cholecystolithi- asis and choiecystectomy （Be called for short gallbladder diseases）. This study was to investigate the association of gallbladder diseases and colorectal cancer. METHODS The clinical data of 1 514 rectal cancer patients （Case group） treated at the Affiliated Tumor Hospital of Xinjiang Medical University from 2010 01-01 to 2014-12-31 were enrolled, the control group were ＇randomly selected from the healthy crowd examed in Affiliated Tumor Hospital of Xinjiang Medical University at the same period and using the systematic sampling method to choose 1 523 as control group. The incidences of gallbladder diseases in two groups were invastigated. Patients with or without gallbladder diseases in the case group were also analyzed on the difference of age, gender, ethnicity, diabetes mellitus（DM）, the higher level of TG, smoke,drink, body mass index（MBI） and the location of tumor. RESULTS The incidence of cholecystolithiasis and cholecystectomy in case group respectively were 81 cases （30.2 %） and 187 cases （69.8 %）, in the control group the incidence of cholecystolithia- sis and eholecystectomy were 44 cases （40.0% ） and 66 cases （60.0 %） ;The ratio in case group was obviously higher than that of health control group （x2 = 52. 239, P〈0. 001;Z2 = 22. 747, P〈0. 001）. Multivariate regression analysis suggested that the higher level of TG （x2 =4. 205,P=0. 040）, DM（x2 = 10. 807,P=0. 001） or ≥60 years old （X2 =4. 954,P= 0. 026） were the risk factors for colorectal cancer development if gallbladder diseases existed, especially for the right colon （P=0. 000）, but had no correlation with gender （x2 =0. 591,P=0. 442）, ethnicity （2 =0. 027,P=0. 870）, BMI （x 2= 3.550,P=0.060）, smoke （x2-0.912,P-0.339） or drink （x2 1. 781,P=0.182）. CONCLUSIONS The probability of the colorectal cancer gruop with gallstones and cholecystectomy was higher than the healthy group.

关 键 词：胆囊结石 胆囊切除 胆囊疾病 大肠癌 

分 类 号：R735.34[医药卫生—肿瘤]