脂肪肝患者腹部手术风险及一级亲属癌症的发病率研究

Research on the risk of abdominal operation in patients with fatty liver and the prevalence of cancer in first-degree relatives

目的探讨脂肪肝患者进行腹部手术的风险,以及患者一级亲属癌症的发病率。方法对70例非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)患者,80例已被证实的丙型肝炎患者(其中40例脂肪肝,40例为非脂肪肝),35例炎症性肠病(inflammatory bowel disease,IBD)患者及70例消化不良患者进行评估。结果各个分组中,患者的性别、年龄及婚姻状况差异无统计学意义(P>0.05)(除IBD患者的年龄较其他各组偏小)。其中IBD患者亲属癌症发病率为19.2%,消化不良发病率为10.8%,伴随脂肪变性的C型肝炎发病率为30.7%,无脂肪变性的C型肝炎发病率为21.0%,NAFLD的发病率为28.8%。随后将各研究组重新分为两组:无脂肪性肝病患者(IBD、消化不良、无脂肪变性的C型肝炎)和脂肪性肝病患者(伴随脂肪变性的C型肝炎、NAFLD)。无脂肪性肝病患者癌症发生率为17%,明显低于脂肪性肝病患者(26.7%,P<0.05)。同时调查了脂肪肝患者腹部手术的风险,结果无脂肪性肝病患者手术发生率为32.0%,低于脂肪性肝病(45.0%,P<0.05)。结论脂肪性肝病可以增加脂肪肝患者腹部手术的风险及一级亲属癌症的发病率。因此阐明脂肪性肝病的潜在原因可以减少癌症的发病率及脂肪肝患者手术的数量。

Objective To investigate the risk of abdominal operation in patients with fatty liver and the prevalence of cancer in first-degree relatives of patients with fatty liver. Methods Seventy patients with nonalcoholic fatty liver disease（ NAFLD）,80 patients with biopsy-proven hepatitis C（ 40 patients with fatty liver and 40 patients without fatty liver）,35 patients with inflammatory bowel disease（ IBD）,and 70 patients with dyspepsia were evaluated. Results There was no difference in sex,mean age,and marital status among the groups,except patients with IBD were younger than the others. The frequency of cancer among family members was 19. 2% in IBD,10. 8% in dyspepsia,30. 7% in hepatitis C with steatosis,21. 0% in hepatitis C without steatosis,and 28. 8% in NAFLD. Then,the patients were divided into two groups as follows： fatty liver group（ IBD ＋ dyspepsia ＋ hepatitis C without steatosis） and non-fatty liver group（ hepatitis C with steatosis ＋ NAFLD）. The frequency of cancer was 17. 0 % in non-fatty liver patients,significantly less than fatty liver patients（ 26. 7 %,P〈0. 05）. This study also investigated the risk of abdominal operation in patients with fatty liver. The results were as follows： 32. 0% in non-fatty liver patients,significantly less than fatty liver patients（ 45. 0%,P〈0. 05）. Conclusion Fatty liver disease might increase the risk of abdominal operation in patients with fatty liver and the prevalence of cancer in first-degree relatives. Understanding the underlying causes of fatty liver forms might decrease the cancer frequency in the population and the number of operations in patients with fatty liver.