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目的探讨不同大小胆囊结石病人患胆囊癌的相对危险度(RR)。方法收集胆囊癌病人154例为病例组,再为每一病例挑选2个与之匹配的非胆囊癌病例构成对照组,共308例。据此计算不同大小胆囊结石病人患胆囊癌的 RR 及其95%可信区间(95%CI)。结果与结石最大径<1cm 组相比,≥2cm 的 RR=4.8,95%CI=2.326～9.932;>13cm 的 RR=5.810,95%CI=2.206～15.305;结石最大径≥2cm 对于<2cm 的 RR=4.254,95%CI=2.206～7.436。95%CI 均不包括 RR=1的点,具有统计学意义。上述各组间病例组与对照组的分布差异显著(x~2检验,P<0.001),与95%CI 的判断相一致。结论结石>2cm 患癌的 RR 是<2cm 的5倍。据此建议≥2cm 的无症状结石应作为患癌的高危倾向和施行胆囊切除的参考依据。
Objective To investigate the relative risk (RR) of gallbladder cancer in patients with different sizes of gallbladder stones. Methods A total of 154 patients with gallbladder cancer were selected as the case group. Two matched non-gallbladder cancer cases were selected as control group, 308 cases in each case. Based on this, the RR of gallbladder cancer and its 95% confidence interval (95% CI) were calculated for gallstone patients with different sizes. Results Compared with the maximum diameter of the stone <1cm group, ≥2cm RR = 4.8,95% CI = 2.326-9.932;> 13cm RR = 5.810,95% CI = 2.206 ~ 15.305; the largest diameter of stones ≥2cm For <2cm RR = 4.254, 95% CI = 2.206 ~ 7.436.95% CI did not include RR = 1 points, with statistical significance. There was significant difference in the distribution of cases between the above groups and the control group (x ~ 2 test, P <0.001), consistent with the 95% CI. Conclusion Stones> 2cm cancer RR is 5 times <2cm. It is suggested that asymptomatic stones ≥ 2cm should be used as a high risk of cancer risk and the implementation of cholecystectomy reference.