对肝脏,胆囊和胆道癌症的个人并发症的人口可归因的部分
Kari Hemminki1,2,3, Kristina Sundquist3,4,5, Jan Sundquist3,4,5
1Biomedical Center, Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 323 00 Pilsen, Czech Republic.
13种常见的并发症对肝胆道癌症有显著的贡献,包括肝脏,胆囊和胆道癌症. 识别这些风险因素,如糖尿病和胆结石,为早期干预和疾病预防提供了机会.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 肝胆道癌,包括肝细胞癌 (HCC),胆囊癌 (GBC),肝内 (ICC) 和肝外胆道癌 (ECC),以及囊癌,对健康造成重大负担.
- 对于有针对性的预防策略来说,了解易感性并发病的人口归因分数 (PAF) 是至关重要的.
研究的目的:
- 估计与主要肝胆道癌症相关的13种特定并发症的人口归因分数 (PAF).
- 确定导致HCC,GBC,ICC,ECC和皮癌发病率的关键风险因素.
主要方法:
- 使用瑞典住院病例登记 (1987-2018) 的患者数据和瑞典癌症登记 (1997-2018) 的癌症数据,采用了一个队列研究设计.
- 针对每种共发病与癌症的关联,计算出了人口归因分数 (PAF).
主要成果:
- 糖尿病,与酒精有关的肝病和型肝炎病毒是男性HCC (PAF>10%) 的主要原因.
- 糖尿病和自身免疫性疾病对女性HCC具有重要意义;胆结石疾病是两性GBC的主要驱动因素 (PAF30.57%).
- 男性ICC的PAF几乎是女性ICC的两倍,胆道感染是ECC和囊癌的关键.
结论:
- 研究的并发症解释了大多数肝胆癌的病因途径的至少50%,但女性ICC除外.
- 慢性炎症可能在几十年内发展,可能是这些癌症的统一机制,突出了干预和监测的途径.
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