摘要
目的探讨肥城市居民食管鳞癌的危险因素.方法采用病例-对照设计,253例患者一部分来自对40~69岁居民采用染色内镜普查发现的病例,另一部分来自肥城市人民医院病例;以内镜普查食管黏膜正常者作为指示对照组(8159名).所有参加普查者首先进行心电图和B超腹部检查、问卷调查和内镜检查;问卷调查包括吸烟、饮酒及饮食因素等.内镜检查发现碘不染色者取活检进行病理检查,由2位病理医生进行诊断.采用二项式logistic回归分析与食管癌有关联的因素.研究取得医科院伦理道德委员会批准,参加者签定知情同意书.结果病例组253例(2004年1月至2006年12月内镜普查发现食管癌70例,同期住院患者183例),食管黏膜碘染色8159名为对照组.单因素分析发现年龄、性别和文化水平与食管癌有关联,在分析其他因素时将这3个因素作为混杂因素进行调整.调整上述3因素后,发现吸烟和饮酒增加食管癌的危险性;将吸烟和饮酒结合分析发现既吸烟又饮酒的男性患食管癌的危险性OR=2.73(95%CI:1.54~4.82),人群归因危险性为51.47%.一级亲属有食管癌家族史也增加患病的危险性;饮食营养分析发现,食物纤维素和维生素C的摄入量增加可减低食管癌的危险性.结论吸烟和饮酒增加食管癌发生的危险性,而增加纤维素和维生素C的摄入量可减低食管癌的危险性.
Objective To investigate the risk factors related to the esophageal squamous cell cancer in Feicheng county in Shandong province.Methods A case-control study was caried out in Feicheng county.There were two parts consisted in the cases.253 cases,aged from 40 to 69 years old,were recruited from the screened endoscopic survey program from January 2004 to December 2006.The other part of cases was recruited from the people's Hospital of feicheng city.8159 subjects whose had nornal endoscope test result were recruited as the control group.Besides cardiograph and ventral ultrasound examination the screening program also included an endoscope test during which mucosal stain with 1.2%iodine solution.The biopsies were taken from the screen and underwent pathologic evaluation by two pathologists;A self-administrative questionnaire survey was conducted in all the subjects to collect information about smoking,alcohol consumption and dietary.The binary Logistic regression was used to estimate odds ratio(OR)and 95%confdence interval(95%CI).The study protocol was approved by the local ethics committee and the study was conducted with the informed consents of all the study subjects.Results There were 235 esophageal cancers cases(70 identified in screening program,183 were hospitalized patients)and 8159 controls in the case-control study.Three potential confounders were detected after univariate analysis.After adjusted the three confounders,age,sex and education,we found,smoking,alcohol drinking were the top ranked risk factors for esophageal cancer.When combing smoking and alcohol drinking,the or was 2.73(95%CI:1.54-4.82)for male,and the proportional attribute relative risk was 51.47%.We also observed that more dietary cellulose and vitamin C intake have protective effects.Conclusion Smoking and alcohol drinking could increase the risk of esophageal cancer,and taking more dietary cellulose and vitamin C might decrease the risk.
作者
李会庆
刁玉涛
李颢
周英智
杨艳芳
房学强
王燕
吴侃
赵德利
周瑞雪
雷复华
LI Hui-qing;DIAO Yu-tao;LI Hao;ZHOU Ying-zhi;YANG Yan-fang;FANG Xue-qiang;WANG Yan;WU Kan;ZHAO De-li;ZHOU Rui-xue;LEI Fu-hua(The Institute of Basic Medicine,Shandong Academy of Medical Sceinces.Jinan 250062,China;不详)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2007年第S01期56-61,共6页
Chinese Journal of Preventive Medicine
基金
国家自然科学基金资助(30571601)
山东省2004年科学技术发展(重大专项部分)项目资助(2004GG1108039)
关键词
食管肿瘤
危险因素
饮食习惯
回归分析
Esophageal neoplasms
Risk factors
Food habits
Regression analysis
