| 王仲阁,尹 春,张李珍,等.基于金昌队列的常规循环肝功能标志物与结直肠癌发病关系的巢式病例对照研究[J].中国肿瘤,2023,32(10):789-796. |
| 基于金昌队列的常规循环肝功能标志物与结直肠癌发病关系的巢式病例对照研究 |
| A Nested Case-Control Study on Relationship of Circulating Liver Function Markers with Incidence of Colorectal Cancer Based on Jinchang Cohort |
| 投稿时间：2023-03-14 |
| DOI：10.11735/j.issn.1004-0242.2023.10.A011 |
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| 中文关键词: 金昌队列 结直肠癌 循环肝功能标志物 巢式病例对照研究 白蛋白 总胆红素 |
| 英文关键词:Jinchang cohort colorectal cancer circulating liver function markers nested case-control study albumin total bilirubin |
| 基金项目:校企合作项目（金科综2020-02） |
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| 摘要点击次数: 316 |
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| 中文摘要: |
| 摘 要：［目的］ 探索常规循环肝功能标志物与结直肠癌发病风险的关系。［方法］ 采用巢式病例对照研究，剔除基线慢性结肠炎、肠息肉和恶性肿瘤患者及基本资料不全者，以金昌队列3次随访期间新发结直肠癌患者145例为病例组，以随访未发生结直肠癌的人群作为对照来源，根据同期随访、基线年龄±2岁和同性别进行1∶4个体匹配，获得对照组580名，最终纳入725名研究对象。通过条件Logistic回归分析探究常规循环肝功能标志物与结直肠癌发病风险的关系，计算比值比（odds ratio，OR）及其95%置信区间（confidence interval，CI），采用限制性立方样条分析相关因素与结直肠癌发病的剂量-反应关系。［结果］ 研究对象平均年龄为61.24岁，男性占比71.72%。多因素条件Logistic回归分析结果显示，在调整混杂因素后，发现总胆红素第2四分位数组研究对象发生结直肠癌的风险是第1四分位数组的0.490倍(OR=0.490，95%CI：0.273~0.879)，处于白蛋白第2、3、4四分位数组的研究对象发生结直肠癌的风险分别较处于第1四分位数组的研究对象降低41.6%(OR=0.584，95%CI：0.342~0.996)、42.9%(OR=0.571，95%CI：0.337~0.970)和42.7%(OR=0.573，95%CI：0.330~0.996)。对结直肠癌发病部位进行分区，以白蛋白第1四分位数组为对照，第3、4四分位数组的个体发生结肠癌的风险分别降低66.6%(OR=0.334，95%CI：0.139~0.804)和80.7%(OR=0.193，95%CI：0.066~0.566)。未发现白蛋白与直肠癌发病风险之间具有统计学意义。白蛋白与结直肠癌发病风险之间存在明显的负向线性剂量-反应关系(P总趋势<0.050，P非线性=0.191)，结直肠癌发病风险随白蛋白的升高而降低。［结论］ 白蛋白和总胆红素水平的升高与结直肠癌发病风险降低相关，且白蛋白与结直肠癌的发病风险存在剂量-反应关系。白蛋白与结肠癌发病风险存在较强的负相关性，而与直肠癌不存在关联。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the relationship between conventional circulating liver function markers and the risk of colorectal cancer. ［Methods］ The nested case-control study method was adopted in the study. Excluding those with chronic colitis， intestinal polyps and malignant tumors and incomplete basic information in the baseline population， 145 new cases of colorectal cancer during the follow-up period of the cohort were selected as the case group. In those without colorectal cancer during follow-up， 580 controls were matched according to the same period， same gender and similar age(±2 years) of patients participating in the cohort. Univariate and multivariate conditional Logistic regression models were used to explore the relationship between conventional circulating liver function markers and colorectal cancer risk. Restricted cubic splines were used to analyze the dose-response relationship between related factors and the risk of colorectal cancer. ［Results］ The average age of the participants was 61.24 years old， and males accounted for 71.72%. The results of multivariate conditional Logistic regression analysis showed that after adjusting for relevant confounding factors， the risk of colorectal cancer in the second quantile of total bilirubin was 0.490 times that of the first quantile(OR=0.490， 95%CI： 0.273~0.879)， and the risks of colorectal cancer in the second， third and fourth quartiles of albumin were reduced by 41.6%(OR=0.584，95%CI：0.342~0.996)，42.9%(OR=0.571，95%CI：0.337~0.970)and 42.7%(OR=0.573，95%CI：0.330~0.996) compared with the first quantile respectively. For the colon cancer， individuals in the third and fourth quartiles of albumin the risk was reduced by 66.6%(OR=0.334， 95%CI： 0.139~0.804) and 80.7%(OR=0.193， 95%CI： 0.066~0.566)， respectively， compared with that in the first quartile. No statistically significant association between albumin and the risk of rectal cancer was found. There was a significant negative linear dose-response relationship between albumin and colorectal cancer risk(P for overall <0.050， P for non-linear=0.191). ［Conclusion］ Elevated levels of albumin and total bilirubin are associated with a reduced risk of colorectal cancer， and there is a linear dose-response relationship between albumin and the occurrence of colorectal cancer. There is a stronger negative association between albumin and colon cancer risk， but not with rectal cancer. |
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