原发性肺腺癌危险因素病例对照研究

Risk factors of primary lung adenocarcinoma:a case-control study

目的探讨原发性肺腺癌的影响因素。方法采用病例对照研究方法,研究对象为福建省原发性肺腺癌病例306例和经年龄、性别频数配比的对照人群437人;应用单因素及多因素非条件logistic回归等方法对肺腺癌的影响因素及其交互作用进行分析。结果对照组和病例组居住地附近有污染企业的分别有47人(10.8%)和75例(24.5%),居室通风情况不佳分别有45人(10.3%)和68例(22.2%),做饭时室内有烹调油烟分别有202人(46.2%)和210例(68.6%),炒菜时油温不过热(不冒油烟)分别有243人(55.6%)和119例(38.9%),吸烟>30包年分别有110人(25.2%)和117例(38.2%),家庭及工作场所被动吸烟分别有129人(29.5%)和127例(41.5%)及92人(21.1%)和127例(41.5%),饮绿茶分别有88人(20.1%)和39例(12.7%),使用农药分别有72人(16.5%)和82例(26.8%);多因素logistic回归分析结果表明,肺腺癌的危险因素有居住地附近有污染企业、居室通风不良、室内烹调油烟、吸烟>30包年、家庭及工作场所被动吸烟、使用农药、近10年有负性事件发生;其中居住地附近有污染企业、烹调油烟量、家庭被动吸烟、工作场所被动吸烟之间存在交互作用,男、女性肺腺癌的主要影响因素有差异。结论不良的居家环境、主动及被动吸烟、农药的使用及消极的心理因素均将增加居民肺腺癌发病危险,适当的炒菜油温、饮绿茶及经常以步代车对肺腺癌发病有一定的保护作用。

Objective To investigate the influencing factors of primary lung adenocarcinoma. Methods The sub- jects included 306 lung adenocarcinoma cases and 437 age-gender-matched health controls recruited from local popula- tion. The odds ratios（ORs） and their 95% confidence interval（CI） of all factors which entered unconditional logistic regression model were calculated. Results In multivariate unconditional logistic regression analysis, ambient air pollu- tion,insufficient indoor ventilation, indoor cooking oil fume, smoking pack-year 〉 30, environmental tabacco smoking （ETS） at home and work place, usage of pesticide, and major adverse event in last 10 years were risk factors of lung ade- nocarcinoma with the adjusted ORs of 2. 127 （ 95% CI： 1. 339 - 3. 377 ）, 2. 271 （ 95% CI： 1. 388 - 3. 715 ）, 4. 177 （95% CI：1.459-11.958）,2.422（95% CI：1.339-4.381 ）,1.511（95% CI：1.032-2.212 ）,2.292（95% CI： 1. 442 -3. 642 ）, and 2. 354 （95 % CI： 1. 243 -4. 456 ）, respectively. Cooking with medium temperature, intake of green tea, and frequent physical activity in last 10 years were protective factors of lung adenocarcinoma with the adjusted ORs of 0. 416（95% CI：0. 259 -0. 667 ） ,0. 471 （95% CI：0. 276 -0. 802 ） ,and 0. 442（95% CI：O. 292 -0. 669 ）. The inter- action effects between ambient air pollution and cooking oil fume, ETS at home and work place were indentified among all influential factors. There were some differences in the influencing factors between the men and the women. Conclu- sion Ambient air pollution,insufficient indoor ventilation, cooking oil fume, smoking, ETS at home and work place,us- age of pesticide, and major adverse event in last 10 years could increase the risk of lung adenocarcinoma. Cooking with medium temperature,intake of green tea, and frequent physical activity in last 10 years may reduce the risk of lung adenocarcinoma.