唐山地区女性乳腺癌环境危险因素的病例对照研究

A Case-control Study on Environmental Risk Factors of Female Breast Cancer in Tangshan Area

[目的]探讨唐山地区女性乳腺癌的环境危险因素。[方法]采用1：1配比的病例对照研究，对经病理确诊的166例女性乳腺癌病人匹配对照后进行条件logistic回归分析。[结果]单因素分析显示：室内杀虫剂使用年限长、有机溶剂暴露年限长、农药暴露年限长、放射线检查次数多、体重指数高、精神刺激、行经年数长、流产次数多为危险因素；而水果、豆制品摄入次数和生育胎次多为保护因素。多因素分析显示：室内杀虫剂使用年限长（OR=1、747，95％CI：1．163～2．624，P=0．007）、有机溶剂暴露年限长（OR=2．221，95％CI：1．005～4．125，P=0．037）、体重指数高（OR=1．661，95％CI：1．110～2．486，P=0．014）、精神刺激（OR=I．923，95％CI：1．352～3．968，P=0．041）为危险因素；水果摄入次数多（OR=0．751，95％CI：0．591-0．954，P=0．019）、豆制品摄入次数多（OR=0．732，95％CI：0．570～0．939，P=0．014）和生育胎次多（OR=O．314，95％CI：0．129～0．766，P=0．011））为保护因素。市区组与县郊区组的环境危险因素存在一定差别。[结论]唐山地区女性乳腺癌危险因素中，室内杀虫剂使用、有机溶剂暴露、饮食因素等环境因素起着重要的作用。

[ Objective ] To explore the environmental risk fa ctors of female breast cancer in Tangshan area. [ Methods ] 1 ： 1 matched case-control study was conducted in 166 cases of breast cancer with histopathological diagnosis and 166 matched controls, using conditional logistic regression analysis. [ Results ] Univariate conditional logistic regression analysis showed the duration of using indoor pesticides, the duration of exposure to organic solvents and pesticides, frequent radiation examination, high body mass index, psychological irritation, long menstrual years and repeated abortion were risk factors; whereas high intake times of fruits and soybean food, more parity were protective factors. Multivariate conditional logistic regression analysis sfiowed the long duration of indoor pesticides use（ OR=1.747, 95%CI： 1.163-2.624, P=0.007 ）, the long duration of organic solvents exposure（ OR=2.221, 95%CI： 1.005-4.125, P=0.037 ）, high body mass index（ OR=1.661, 95 %CI： 1.110-2.486, P=0.014 ）, psychological irritation （ OR=1.923, 95 %CI： 1.352-3.968, P=0.041 ） were risk factors ; high intake of fruits（ OR=0.751, 95%CI： 0.591-0.954, P=0.019 ）and soybean food（ OR=0.732, 95%CI： 0.570-0.939, P=0.014 ）, more parity （ OR=0.314, 95%CI： 0.129-0.766, P=0.011 ）were protective factors. Environmental risk factors of female breast cancer differs between women living in city and women living in rural area. [ Conclusion ] Environmental factors such as duration of indoor pesticides use, duration of exposure to organic solvents and dietary factors played important role in female breast cancer in Tangshan area.