| 张 瑞,李 贺,李 霓.基于中国城市大规模人群筛查队列的上消化道癌危险因素巢式病例对照研究[J].中国肿瘤,2021,30(5):321-327. |
| 基于中国城市大规模人群筛查队列的上消化道癌危险因素巢式病例对照研究 |
| Nested Case?鄄control Study of Risk Factors for Upper Gastrointestinal Cancer Based on Population Screening Cohort in Urban Areas of China |
| 中文关键词 修订日期：2020-10-22 |
| DOI：10.11735/j.issn.1004-0242.2021.05.A001 |
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| 中文关键词: 上消化道癌 巢式病例对照研究 危险因素 筛查 |
| 英文关键词:upper gastrointestinal cancer nested case-control study risk factors screening |
| 基金项目:国家科技基础资源调查专项（2019FY101105）；中国医学科学院中央级公益性科研院所基本科研业务费专项资金（2019PT320027）；国家重点研发计划（2016YFC0901400） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨中国城市人群上消化道癌发病的危险因素，为上消化道癌高危人群的筛选提供依据。［方法］ 以国家重大公共卫生专项城市癌症早诊早治项目人群队列为基础，对城市社区40~74岁人群开展问卷调查。在选定的项目省份参加问卷调查的人群中，选择经被动随访发现且资料齐全的上消化道癌患者825例组成病例组；在未患上消化道癌的人群中，以同一年进入队列、性别相同、基线年龄相近（±5岁）进行1∶3个体化匹配，共匹配对照2475例。通过对体质指数（body mass index，BMI）、生活行为及饮食习惯、疾病史及上消化道癌家族史等因素进行单因素分析筛选变量，进一步采用多因素Logistic回归分析影响上消化道癌发生的因素，并计算相关因素的比值比（odds ratio，OR）及其95%可信区间（95% confidential interval，95%CI）。将上消化道癌病例分为食管癌与胃癌，分别构建分析数据集，分析单一癌种发病风险的影响因素。［结果］ 病例组和对照组中位年龄均为62岁，男性占72.12%，中位随访时间1.26年。多因素Logistic回归分析发现，BMI<18.5kg/m2（OR=2.103，95%CI：1.274~3.473）、文化水平较低（OR=1.239，95%CI：1.020~1.505）、经常食用腌制食品（OR=1.419，95%CI：1.146~1.757）、正在吸烟（OR=1.389，95%CI：1.162~1.662）、具有上消化道癌家族史（OR=1.626，95%CI：1.261~2.096）是上消化道癌发生的危险因素。食管癌发生的危险因素包括文化水平较低、低BMI、喜食烫食、正在吸烟、有上消化道癌家族史。经常食用腌制食品、吸烟、具有上消化道疾病史和癌症家族史会增加胃癌的发病风险。［结论］ 正在吸烟者、BMI<18.5kg/m2、经常食用腌制食品和具有上消化道癌家族史者是上消化道癌的高危人群，提示这几类人群为上消化道癌筛查的重点关注人群。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the risk factors of upper gastrointestinal cancer in China，and to provide evidence for screening high-risk groups of upper gastrointestinal cancer. ［Methods］ Based on the population cohort of the National Major Public Health Special Cancer Screening Program in Urban China，a questionnaire survey was conducted among people aged 40～74 in urban communities. Among the population who filled in the questionnaire in the selected provinces，825 upper gastrointestinal cancer patients with complete information found through passive follow-up were selected as the case group. In those without upper gastrointestinal cancer，2475 controls were matched according to the same year，same gender and similar age(±5 years) of patients participating in the cohort. The risk factors of upper gastrointestinal cancer，as well as the risk factors for esophageal cancer and gastric cancer，were analyzed with univariate and multivariate Logistic regression. ［Results］ The median age of case and control groups were both 62 years old，male accounted for 72.12%，and the median follow-up time was 1.26 years. Multivariate Logistic regression analysis showed that BMI<18.5kg/m2(OR=2.103，95%CI：1.274~3.473)，low education level(OR=1.239，95%CI：1.020~1.505)，eating pickled food frequently(OR=1.419，95%CI：1.146~1.757)，current smoking(OR=1.389，95%CI：1.162~1.662)，family history of upper gastrointestinal cancer(OR=1.626，95%CI：1.261~2.096) were risk factors for upper gastrointestinal cancer. Risk factors for the occurrence of esophageal cancer included low education level，low BMI，hot food preference，current smoking，and family history of upper gastrointestinal cancer；while those for gastric cancer were eating pickled food frequently，smoking，and history of upper gastrointestinal disease and family history of upper gastrointestinal cancer. ［Conclusion］ People who have low body weight(BMI<18.5kg/m2)，smoke currently，eat pickled food frequently，and have a family history of upper gastrointestinal cancer should be treated as high-risk group in screening upper gastrointestinal cancer. |
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