摘要
目的 利用Meta分析筛选中国人群肺癌的危险因素及其关联强度,探索性地建立适合中国人群的肺癌风险评估模型,为我国人群肺癌预防控制策略和措施的制定提供科学依据.方法 计算机检索中国生物医学文献数据库（CBM）、维普、万方、知网以及Pubmed、Cochrane、EMbase等数据库,并辅以手工检索、文献追溯法,收集1995年1月至2017年6月国内外关于中国人群肺癌危险因素的相关文献,并采用NOS量表对纳入文献的质量进行评价,利用RevMan5.2软件进行Meta分析.结果 本研究共43篇文献最终纳入Meta分析,全部为病例对照研究,累计肺癌病例8604例,对照10306例.中国人群肺癌发病的危险因素有吸烟2.65（1.72-3.98）、被动吸烟2.11（1.38-3.16）、家庭场所被动吸烟1.73（1.42-2.06）、工作场所被动吸烟1.54（1.26-1.84）、取暖煤烟1.97（1.51-2.54）、室内装修4.99（1.21-6.76）、肺癌家族史2.62（1.45-4.56）、肺结核史3.42（1.68-6.66）、慢性支气管炎3.14（1.79-5.32）、腌熏制食品2.67（1.96-3.59）、动物内脏2.01（1.56-2.73）、A型性格2.74（1.82-4.01）、心理压力2.17（1.54-2.95）;保护因素有新鲜蔬菜0.27（0.11-0.74）、新鲜水果0.64（0.51-0.83）、饮茶0.72（0.65-0.85）和体育锻炼0.69（0.54-0.87）.结论 ①中国人群肺癌发生的危险因素主要为：室内装修史、精神创伤史、肺结核史、慢性支气管炎史、A型性格、腌熏酸食品、家族肿瘤史、精神压抑、吸烟、烹饪油烟、心理压力、性格抑郁、被动吸烟、动物内脏、取暖煤烟、家庭被动吸烟、工作被动吸烟（OR值依次递减）;②新鲜蔬菜、新鲜水果、体育锻炼以及饮茶是肺癌发病的保护因子.GSTP1基因多态性和NQO1基因多态性与肺癌的发病没有关系;③中国人群肺癌危险因素归因百分比显示：室内装修史、精神创伤史的归因百分比最高,提示肺癌的发生与室内环境污染和精神心理方面密切相关.
Objective To investigate the risk factors of lung cancer screening of the Chinese populution and the associated intensity by using Meta analysis,exploratory establishment of a risk assess-ment model for Chinese populution,for our country crowd lung cancer prevention and formulation of measures to provide basis. Methods Computer retrieval CBM,VIP,ten thousand party,hownet and Pubmed,the Cochrane,EMbase database,supplemented by manual retrieval,literature tracing method. The related literature about Chinese population at home and abroad about lung cancer risk factors were collected from January 1995 to June 2017,the quality of literature was evaluated by USES and Nos scale, and using RevMan5. 2 software for Meta analysis. Results A total of 43 literatures in this study were fi-nally included in the Meta-analysis,all of which were case-control studies,and 8604 cases with total lung cancer were reported,compared with 10306 cases. Risk factors of lung cancer in Chinese patients with smoking 2. 65（1. 72 - 3. 98）,passive smoking 2. 11（1. 38 - 3. 16）,passive smoking family 1. 73 （1. 42 - 2. 06）,passive smoking workplace 1. 54（1. 26 - 1. 84）,heating soot 1. 97（1. 51 - 2. 54）,in-door decoration 4. 99（1. 21 - 6. 76）,family history of lung cancer 2. 62（1. 45 - 4. 56）,history of tuber-culosis 3. 42（1. 68 - 6. 66）,chronic bronchitis 3. 14（1. 79 - 5. 32）,pickled smoked food 2. 67（1. 96 -3. 59）,animal innards 2. 01（1. 56 - 2. 73）,type A personality 2. 74（1. 82 - 4. 01）,psychological pres-sure 2. 17（1. 54 - 2. 95）;protective factors include fresh vegetables 0. 27（0. 11 - 0. 74）,fresh fruits 0. 64（0. 51 - 0. 83）,tea drinking 0. 72 （0. 65 - 0. 85）,and physical exercise 0. 69 （0. 54 - 0. 87）. Conclusions ①The risk factors of Chinese population for lung cancer are mainly：indoor decoration his-tory,history of trauma,pulmonary tuberculosis,chronic bronchitis,type A personality,pickled smoked acid food,family history of cancer,depressed spirit,smoking,cooking oil fume,psychological stress, depressed,passive smoking,animal offal,heating soot work,family and passive smoking （OR re-duced）;②Fresh vegetables,fresh fruit,exercise and tea drinking are protective factors for lung cancer. GSTP1 gene polymorphism and NQO1 gene polymorphism have no relationship with lung cancer;③ Lung cancer risk factors of Chinese population attribution percentage shows that：the history of interior decora-tion,high percentage of attribution of mental trauma history,prompt that the occurrence of lung cancer is closely related to the indoor environment pollution and mental factors.
出处
《中国实用医刊》
2017年第24期122-126,共5页
Chinese Journal of Practical Medicine
基金
“十二五”国家科技重大专项（2012ZX10004905-004-002）
郑州市科技惠民计划项目（163PKJHM196）
关键词
肺癌
危险因素
中国人群
META分析
Lung cancer
Risk factors
Chinese population
Meta-analysis
