目的：探讨壶腹周围癌发病的相关危险因素，为有效预防和控制壶腹周围癌提供理论依据。 方法：采用1:1配对病例对照研究，收集湖南省人民医院肝胆外科2003—2014年间122例壶腹周围癌患者（病例组）和同期122例非肿瘤、非消化系统疾病患者（对照组），对可能的危险因素进行条件Logistic回归分析。 结果：在控制了混杂因素后，壶腹周围癌的危险因素为吸烟、饮酒及乙肝感染。其结果为，随着每日吸烟量（支）的增加壶腹周围癌的患病率随之增加，其中现在不吸烟者、<20支/d、20~39支/d、≥40支/d者的优势比（OR）分别为0.450（95% CI=0.205~0.988）、0.500（95% CI=0.092~2.730）、 2.571（95% CI=1.074~6.156）、3.000（95% CI=0.312~28.841）；每日饮酒<40 g、40~99 g、≥100 g者患壶腹周围癌的OR值分别为3.000（95% CI=0.312~28.841）、65.289（95% CI=0.006~70.239）、4.50（95% CI=0.972~20.827）；乙肝感染者患壶腹周围癌的危险性是无乙肝病史者的3.25倍（95% CI= 1.060~9.967）。 结论：大量吸烟、饮酒以及乙肝感染是壶腹周围癌的危险因素。
Risk factors for periampullary carcinoma: a case-control study
Objective: To determine the relevant risk factors for the pathogenesis of periampullary carcinoma, so as to provide a theoretical reference for effective prevention and control of this conditioin. Methods: Using a 1:1 case-control matched design, 122 patients with periampullary carcinoma (case group) admitted during 2003 to 2014 and 122 patients without tumor or digestive disease admitted during the same period in Hunan Provincial People’s Hospital were enrolled. The possible risk factors were analyzed by conditional Logistic regression model. Results: Smoking, alcohol consumption and hepatitis B virus (HBV) infection were found to be the risk factors for periampullary carcinoma after controlling for confounding factors. The results showed that the risk of periampullary carcinoma increased in proportion with the increase in the number of cigarettes smoked per day, and odds ratio (OR) was 0.450 (95% CI=0.205–0.988), 0.500 (95% CI=0.092–2.730), 2.571 (95% CI=1.074–6.156) and 3.000 (95% CI=0.312–28.841) for those who did not currently smoke, smoked <20 cigarettes/d, 20–39 cigarettes/d and >40 cigarettes/d, respectively; the OR was 3.000 (95% CI=0.312–28.841), 65.289 (95% CI=0.006–70.239) and 4.500 (95% CI=0.972–20.827) for those who with alcohol consumption less than 40 g/d, 40-99 g/d and >100 g/d, respectively; the risk of periampullary carcinoma in cases with HBV infection was 3.25-fold higher than in those without history of HBV infection (95% CI=1.060–9.967). Conclusion: Heavy smoking, alcohol consumption and HBV infection are associated with increased risk of periampullary carcinoma.