喉癌下咽癌患者的危险因素分析

Analysis of risk factors for laryngeal and hypopharyngeal cancers

为探讨喉癌下咽癌的发生与吸烟饮酒及染色体敏感性等因素的关系，对154例喉癌和下咽癌患者及107位正常人做病例对照研究。结果显示吸烟和饮酒者的患癌风险明显高于非吸烟饮酒者，患癌风险随烟酒用量的加大而增加。染色体对致突变剂的敏感性实验显示，每细胞染色单体断裂率（b／c值）是一反映机体对致突变物或致癌物敏感性的重要标志。以b／c值0．40为敏感值时，病例组中约80％高于此值，对照组中80％低于此值。根据研究结果我们认为喉癌下咽癌的发生主要由体质性因素所决定，喉癌和下咽癌患者是人群中对致癌物敏感性增高者再加上长期吸烟和饮酒等环境因素的作用而发展为癌。

A case-controlled study in laryngeal and hypopharyngeal cancers was carried out atthe Affiliated Hospital of Shandong Medical University. The sensitivity to BleomycinA5-induced chromosome damage in 154 patients with previously untreated squamous cellcarcinoma was compared with that in 107 healthy controls. The risk factors associatedwith tobacco and alcohol consumption were analized. A significant increase of chromo-some sensitivity was found in patients, which was not related to well-known cancer riskfactors such as age, tobacco and alcohol consumption. Odds ratios (OR) for chromo-some sensitivity significantly elevated in patients (OR= 12. 64 for laryngeal cancer, 19.48 for hypopharyngeal cancers)- Based on our observation, we consider that thedevelopment of laryngeal and hypopharyngeal cancers is mainly determined by a consti-tutional factor. People who are sensitive to carcinogens genetically are susceptible todevelop cancer by adding environmental carcinogens like tobacco and alcohol.