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J Gastroenterology H:有症状的胆石症患者患胰腺癌的风险明显增加

2021-05-30 MedSci原创 MedSci原创

胰腺癌是一种致命的疾病,只有一小部分患者有幸可以接受手术进行切除。即使是那些可以手术切除的患者胰十二指肠切除术后的5年生存率也小于30%,而 T1 肿瘤患者仅10%。

      胰腺癌是一种致命的疾病,只有一小部分患者有幸可以接受手术进行切除。即使是那些可以手术切除的患者胰十二指肠切除术后的5年生存率也小于30%,而 T1 肿瘤患者仅为10%。直到现在R0切除术仍然是唯一能保证胰腺癌患者存活的治疗方法。在过去的 5 年中,一些队列研究表示胆结石和胆囊切除术(CCY) 是胰腺癌的重要危险因素。因此,本项研究的目的是评估胆石症和胆石症治疗对胰腺癌风险的作用。

 

      研究人员对 2005 年 1 月至 2009 年 12 月期间获得的 100 万个随机样本中选择了有症状的胆石症入院成人患者。对照组以 1:1 的性别、年龄、慢性胰腺炎和胰腺囊性疾病的比例进行了匹配。在胆石症和对照组中计算随后发生的胰腺癌概率。胆石症组进一步分为内镜括约肌切开术/内镜乳头球囊扩张术、胆囊切除术、内镜下括约肌切开术/内镜乳头球囊扩张术和胆囊切除术、无干预组进行进一步评估。

 

      研究结果显示胆石症组和匹配的对照组总共有8265名成年人。胆石症组中发生胰腺癌86例,对照组中只有8例(P< 0.001)。胆石症组后续胰腺癌的发生率比(IRR)显着高于对照组(IRR:5.28,P< 0.001)。与胆囊切除术组相比,无干预组随后胰腺癌的 IRR 更高(IRR= 3.21,P= 0.039),但在其他治疗亚组中相似。

图:不同手术处理组的胆管结石患者发生胰腺癌的风险

      本项研究证实有症状的胆石症患者是胰腺癌高发的危险因素,但是无论为胆石症选择何种干预措施,胰腺癌的发生风险都是相似的。

 

 

原始出处:

Chi‐Chih Wang. Et al. Symptomatic cholelithiasis patients have an increased risk of pancreatic cancer: A population-based study. Journal of Gastroenterology and Hepatology. 2021.

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    2021-09-02 许安
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