3922例胆囊癌相关危险因素的分析

目的 总结全国２８个省市自治区的３９２２例胆囊癌临床流行病学调查（１９８６～１９９８年）的结果。方法 分析了我国胆囊癌和胆囊结石的,胆囊结石大小和胆囊癌的关系,胆结石的病程,以及胆囊腺瘤和胆道蛔虫病和胆囊癌的关系。结果 （１）我国胆囊癌占同期胆道疾病的构成比０．４％～３．８％,平均为１．５３％,胆囊癌在同期普通外科疾病的构成比为０．１％～１．１％,平均为０．２８％。（２）胆囊癌合并胆结石的发生率为

Relative risk factors analysis of 3,922 cases of gallbladder cancer

OBJECTIVE: To make clear the relationship between gallstones and gallbladder cancer, the relationship between the size of gallstones and gallbladder cancer, the course of gallbladder cancer, and the relationship among adenoma and carcinoma of gallbladder and ascariasis in the biliary tract. METHODS: A total of 3,922 cases of gallbladder cancer from 28 provinces in china from 1986 to 1998 were reviewed, according to a standard protocol called "the clinical epidemiological list of gallbladder cancer". RESULTS: Gallbladder cancer accounted for 0.4% - 3.8% of bile tract disease in the same period, averaging 1.53%. Gallbladder cancer accounted for 0.1% - 1.1% of abdominal surgery in the same period. Gallstones were found in 46.7% of the cases of gallbladder cancer, the related risk (RR) of gallbladder cancer with gallstones was 13.7. The average course with gallstones was 10 - 15 years. The gallstone in gallbladder was 3 cm or above in diameter. The ratio of the progression from adenoma to carcinoma of gallbladder was 1.5%. Only 4 cases of ascariasis was reported. CONCLUSIONS: Gallbladder cancer and gallstones are closely associated. Patients with gallstone of 3 cm or above in diameter and a course of 10 - 15 years are usually at an increased risk for cancer. We found the adenoma and carcinoma of gallbladder are closely related, and there is no relationship between gallbladder cancer and ascariasis in our group.