Case Control Study
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World J Gastroenterol. Jul 28, 2014; 20(28): 9541-9548
Published online Jul 28, 2014. doi: 10.3748/wjg.v20.i28.9541
Association of metabolic syndromes and risk factors with ampullary tumors development: A case-control study in China
Xiao-Dong He, Qiao Wu, Wei Liu, Tao Hong, Jing-Jing Li, Ruo-Yu Miao, Hai-Tao Zhao
Xiao-Dong He, Qiao Wu, Wei Liu, Tao Hong, Jing-Jing Li, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Ruo-Yu Miao, Hai-Tao Zhao, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: Zhao HT contributed to the conception of the study and designed the protocol; He XD and Wu Q performed clinical data acquisition, the statistical analysis and data interpretation; He XD, Wu Q and Zhao HT wrote the manuscript; Liu W, Hong T, Li JJ and Miao RY helped perform the analysis with constructive discussions; He XD and Wu Q contributed equally to this work.
Supported by A grant (in part) from the Municipal Key Discipline of Beijing, China, No. HK100230446; the National Natural Science Foundation of China, No. 81372578; International Science and Technology Cooperation Projects, No. 2010DFB33720; Program for New Century Excellent Talents in University, No. NCET-11-0288
Correspondence to: Hai-Tao Zhao, MD, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. pumchzht@aliyun.com
Telephone: +86-10-69156024 Fax: +86-10-69156010
Received: November 5, 2013
Revised: February 22, 2014
Accepted: May 19, 2014
Published online: July 28, 2014
Abstract

AIM: To evaluate the risk factors for ampullary adenoma and ampullary cancer.

METHODS: This case-control study included ampullary tumor patients referred to Peking Union Medical College Hospital. Controls were randomly selected from an existing database of healthy individuals at the Health Screening Center of the same hospital. Data on metabolic syndromes, medical conditions, and family history were collected by retrospective review of the patients’ records and health examination reports, or by interview.

RESULTS: A total of 181 patients and 905 age- and sex-matched controls were enrolled. We found that a history of diabetes, cholecystolithiasis, low-density lipoprotein, and apolipoprotein A were significantly related to ampullary adenomas. Diabetes, cholecystolithiasis, chronic pancreatitis, total cholesterol, high-density lipoprotein, and apolipoprotein A were also significantly related to ampullary cancer.

CONCLUSION: Some metabolic syndrome components and medical conditions are potential risk factors for the development of ampullary tumors. Cholelithiasis, diabetes, and apolipoprotein A may contribute to the malignant transformation of benign ampullary adenomas into ampullary cancer.

Keywords: Metabolic syndromes, Ampullary adenoma, Ampullary cancer, Risk factors

Core tip: Although ampullary tumors are relatively rare, the rapid development of, and advances in, endoscopy and imaging techniques have profoundly increased their discovery rate. Despite the increasing numbers of published studies, the etiology for ampullary tumors is incompletely defined. This is the first study to evaluate the impact of metabolic syndromes on ampullary tumors patients.