輸尿管結石與子宮體惡性腫瘤相關性之研究

Relationship between Ureteral Calculus and Uterine Cancer

郭嘉駿(Chia-Chun Kuo)

指導教授 ： 林恆慶

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2014年)

https://doi.org/10.6831/TMU.2014.00100

摘要

背景：根據統計尿路結石的發生率逐年上升，帶來急性疼痛及反覆性發作；近年來的研究顯示慢性發炎與癌症相關性密不可分，而骨盆腔內子宮體惡性腫瘤的發生率及死亡率持續增加，故本研究了解輸尿管結石與子宮體癌症關聯。
目的：探討罹患輸尿管結石的女性病患與後續子宮體惡性腫瘤相關性。
方法：本研究採回溯性世代研究，經由國家研究院全民資料庫中2000年承保抽樣歸人檔(LHID2000)，分析2001年1月1日至2004年12月31日期間診斷為輸尿管結石的女性病患共有5469位，抽樣取得27345位對照組，每一位病患追蹤五年，以評估罹患輸尿管結石後是否與發生子宮體癌症有相關性。
結果：本研究中每十萬人的子宮體癌年發生率在輸尿管結石的實驗組為7.40 (95% 信賴區間為4.70~11.12)，在對照組則為3.38(95% 信賴區間為2.52~4.45)；經由stratified Cox proportional regression運算得知，患有輸尿管結石的病患比起對照組有2.21倍(95% 信賴區間為1.29~3.80，p < 0.01) 罹患子宮體癌的風險。輸尿管結石、肥胖、子宮內膜囊狀增生及高血脂症均為罹患子宮體惡性腫瘤共病因子
結論：經由資料庫的分析輸尿管結石的女性病患，追蹤發現罹患子宮體惡性腫瘤的風險較沒有尿路結石的群體高。

關鍵字

輸尿管結石 ； 子宮體惡性腫瘤 ； 發炎

並列摘要

Background:
The incidence of uterine cancer increases recently in the developed countries. We investigate the relationship between ureteral calculus and uterine cancer in Taiwan.
Objective:
To evaluate the relationship between ureteral calculus and uterine cancer.
Methods:
We used the data sourced from the “Longitudinal Health Insurance Database (LHID2000).”As to the study group, we first identified 5,469 female patients who had received the first-time diagnosis of ureteral calculus from January 1, 2001 to December 31, 2004. This study also used 27,345 female selected subjects as controls. Each subject in this study was individually tracked for a five-year period from their index date to identify those who had subsequently received a diagnosis of uterine cancer during the follow-up period. We performed stratified Cox proportional hazard regressions to evaluate the association between UC and subsequent uterine cancer during the five-year follow-up period.
Results:
Of the study sample of 32,814 patients, 62 patients (0.2%) had uterine cancer during the five-year follow-up period: 19 from the study group (0.4% of patients with UC) and 43 from the comparison group (0.2% of patients without UC). The incidence rate of uterine cancer per 100,000 person-years was 7.40 (95% CI=4.70-11.12) and 3.38 (95% CI=2.52-4.45) for patients with and without UC, respectively. The stratified Cox proportional analysis (stratified by age group, urbanization level, and the year of index date) suggested that the HR of uterine cancer during the five-year follow-up period for patients with UC was 2.21 (95% CI=1.29-3.80, p<0.01) than for those without UC.
Conclusion:
The risk of uterine cancer is higher in the patient who have been previously diagnosed with ureteral calculus.

並列關鍵字

ureteral calculus ； uterine cancer ； inflammation

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