李 贺,曾红梅,邹小农.基于三个非食管癌高发现场的食管鳞癌相关危险因素的探究[J].中国肿瘤,2019,28(10):726-730.
基于三个非食管癌高发现场的食管鳞癌相关危险因素的探究
Risk Factors of Esophageal Squamous Cell Carcinoma in Three Non-High Prevalence Regions of Esophageal Cancer in China
投稿时间:2019-09-23  
DOI:10.11735/j.issn.1004-0242.2019.10.A002
中文关键词:  食管鳞癌  发病  危险因素  前瞻性研究
英文关键词:
基金项目:科技部国家重点研发计划(2018YFC1313100);中国医学科学院医学与健康科技创新工程(2016-I2M-2-004)
作者单位
李 贺 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院 
曾红梅 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院 
邹小农 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院 
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中文摘要:
      摘 要:[目的] 探讨影响中国非食管癌高发区食管鳞癌发病的危险因素。[方法] 采用前瞻性研究设计,对江苏省、山东省及河南省3个非食管癌高发区的32 446名40~69岁研究对象进行前瞻性随访,采用Cox比例风险回归分析探索影响食管鳞癌发生的危险因素。[结果] 本研究基线共纳入32 446名研究对象,男女性别比例为1∶1.34,年龄(53.22±8.10)岁,正在吸烟率和正在饮酒率分别为21.91%和18.23%。在5.01年随访期间,共出现247例食管鳞癌新发病例,食管鳞癌发病密度为150.19/10万人年。多因素Cox回归分析结果显示,高龄(50岁年龄组HR=4.78,95%CI:2.84~8.04,60岁年龄组HR=10.04,95%CI:6.03~16.70),男性(HR=1.43,95%CI:1.05~1.94),具有上消化道癌恶性肿瘤家族史者(HR=1.95,95%CI:1.48~2.58),有食管警示症状者(HR=1.74,95%CI:1.30~2.34),正在吸烟者(HR=1.49,95%CI:1.09~2.03),BMI<22kg/m2(HR=1.31,95%CI:1.01~1.71),低水果摄入者(HR=1.33,95%CI:1.01~1.76),高腌制食物摄入者(HR=1.45,95%CI:1.12~1.88),具有更高的食管鳞癌发病风险。[结论] 高龄、男性、上消化道癌恶性肿瘤家族史、食管警示症状、吸烟、高腌制食品摄入是食管鳞癌发生的危险因素,增加新鲜水果摄入是食管鳞癌发生的保护因素。
英文摘要:
      Abstract:[Purpose] To explore the effects of the major risk factors of esophageal squamous cell carcinoma(ESCC) in three non-high prevalence regions of esophageal cancer in China. [Methods] We performed a population-based cohort of 32 446 individuals,aged 40 to 69 years from three regions of non-high prevalence of esophageal cancer in three provinces of Jiangsu,Shandong and Henan of China. Cox proportional hazards regression analysis was conducted to estimate the potential factors with risk of ESCC. [Results] A total of 32 446 participants were recruited in this study at baseline,with male/female ratio of 1∶1.34,and the average age of(53.22±8.10) years. The prevalence of current cigarette smoking and current alcohol drinking was 21.91% and 18.23%,respectively. During an average 5.01 years of follow-up,247 participants developed ESCC and the incidence density of ESCC was 150.19/100 000 person-years. Multivariate Cox regression analysis showed that ages(for 50s,HR=4.78,95%CI:2.84~8.04;for 60s,HR=10.04,95%CI:6.03~16.70),males(HR=1.43,95%CI:1.05~1.94),those who had family history of upper gastrointestinal cancer(HR=1.95,95%CI:1.48~2.58) and had clinical symptoms of esophageal warning symptoms(HR=1.74,95%CI:1.30~2.34) were more prone to ESCC. In addition,current smoker (HR=1.49,95%CI:1.09~2.03),those who had BMI<22kg/m2(HR=1.31,95%CI:1.01~1.71),lower intake of fresh fruit(HR=1.33,95%CI:1.01~1.76),and higher intake of pickled food(HR=1.45,95%CI:1.12~1.88) were more likely to develop ESCC. [Conclusion] Ages,males,family history of upper gastrointestinal cancer,esophageal warning symptoms,smoking,less BMI,higher intake of pickled food are the risk factors of ESCC,while,higher intake of fresh fruit is the protective factor of ESCC.
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