| 梁 赫,王少明,杨 召.新鲜水果可能降低男性吸烟人群中食管癌的长期死亡风险：林县营养干预试验30年随访研究[J].中国肿瘤,2017,26(12):953-959. |
| 新鲜水果可能降低男性吸烟人群中食管癌的长期死亡风险：林县营养干预试验30年随访研究 |
| Fresh Fruit Intake and Long-term Risk of Esophageal Cancer Among Male Smokers：Finding from the Linxian Nutrition Intervention Trials After 30 Years of Follow Up |
| 投稿时间：2017-06-21 |
| DOI：10.11735/j.issn.1004-0242.2017.12.A006 |
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| 中文关键词: 食管肿瘤 水果 吸烟 前瞻性队列研究 |
| 英文关键词:esophageal neoplasms fruit smoking prospective cohort study |
| 基金项目: |
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| 中文摘要: |
| 摘 要：［目的］ 探讨新鲜水果摄入是否可以降低吸烟人群食管癌的长期死亡风险。［方法］ 选取年龄为40~69岁8862名男性吸烟人群为研究对象，开展基线人口学特征、生活习惯、疾病史及饮食习惯的调查，随后对该人群进行随访至今约30年。以食管癌死亡病例作为研究终点。利用Log-rank检验比较不同新鲜水果摄入频率受试人群中食管癌累积死亡率间的差异。风险比(HR)和95%可信区间(CI)则通过Cox等比例风险模型进行估计，用来表示受试者死于食管癌的相对风险。［结果］ 截至2015年12月31日，共计发生食管癌死亡病例891例。经过30年随访后，男性吸烟人群中，不同新鲜水果摄入频率受试人群中食管癌的30年累积死亡率分别为21.91%、16.48%、14.08%、11.03%和 12.09%，且随着新鲜水果摄入频次的增加，食管癌30年累积死亡率呈下降趋势。与不食用新鲜水果受试人群相比，每月吃、1~3次/周、4~6次/周和每天吃的受试者食管癌的死亡风险分别降低27%（HR=0.73，95%CI：0.61~0.87）、39%（HR=0.61，95%CI：0.50~0.75）、49%（HR=0.51，95%CI：0.35~0.73）和49%（HR=0.51，95%CI：0.35~0.75）。在调整年龄、性别、地区、体重指数、教育水平、饮酒史和家族史、干预因素后，每周摄入新鲜水果1次以上仍可以降低食管癌的死亡风险（HR=0.87，95%CI：0.76~1.00），这种保护性效应在平原地区（HR=0.78，95%CI：0.63~0.96）和无饮酒史（HR=0.82，95%CI：0.68~1.00）的受试人群中尤为明显。［结论］ 新鲜水果的摄入可能降低男性吸烟人群中食管癌的长期死亡风险。 |
| 英文摘要: |
| Abstract：［Purpose］To investigate the long-term risk of esophageal cancer for fresh fruit consumption in male smokers in Linxian. ［Methods］ A cohort of 8862 male smokers participated in the Linxian Nutrition Intervention Trial(NIT) from March to May 1985 and followed up till December 31，2015 with a median of 31.79 years of observation. The primary endpoint was death of esophageal cancer，hazards ratio and 95% confidence interval were calculated using Cox proportional hazard model for fresh fruit consumption. ［Results］A total of 891 esophageal cancer deaths occurred during followed-up. The 30-year cumulative mortality rates of esophageal cancer in the population with different frequency of fresh fruit intake were 21.91%，16.48%，14.08%，11.03%，12.09% respectively，and with the increased frequency of intake of fresh fruits，the tendency of 30-year cumulative mortality rates was decreasing(χ2=175.58，P<0.001). As compared with participants who never or rarely consumed fresh fruit，the risk of esophageal cancer death in participants who consumed fresh fruit monthly，1~3 times/week，4~6 times/week and daily were decreased by 27%（HR=0.73，95%CI：0.61~0.87），39%（HR=0.61，95%CI：0.50~0.75），49%（HR=0.51，95%CI：0.35~0.73）and 49%（HR=0.51，95%CI：0.35~0.75），respectively. After age，sex，region，BMI，education，drinking history，family history and intervention factors were adjusted，the risk of esophageal cancer death decreased by 13%(HR=0.87，95%CI：0.75~1.00) among those who had fresh fruit intake more than once a week，especially among those who lived in plain area(HR=0.78，95%CI：0.63~0.96) or had no history of drinking(HR=0.82，95%CI：0.68~0.99). ［Conclusion］ Higher intake of fresh fruit is probably associated with a lower risk of esophageal cancer death in male smokers in Linxian. |
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