浙江地区女性乳腺癌危险因素的病例对照研究

A case-control study on risk factors of female breast cancer in Zhejiang province

目的:探讨浙江地区女性乳腺癌危险因素,为有效防治乳腺癌提供科学依据。方法:采用1∶1配对的病例对照研究方法,对经病理确诊的200例女性乳腺癌患者及200例匹配对照进行条件logistic回归分析。结果:单因素logistic回归分析显示:恶性肿瘤家族史、乳腺癌家族史、其它肿瘤家族史、近十年有大型装修、乳腺增生、负性生活事件(工作、亲友病故)、文胸含钢圈、睡觉戴文胸、常食肥肉和腌制品、睡眠质量差等能增加乳腺癌的发生;而环保型装饰材料、装修与入住间隔时间长、工作单位性质、哺乳和分娩次数多、常吃水果、充足的睡眠则能降低相关风险性。多因素logistic分析显示有意义的危险因素有:其它肿瘤家族史(OR=1.571,95%CI:1.029～2.396)、乳腺增生(OR=3.066,95%CI:1.834～5.126)、工作负性事件(OR=4.575,95%CI:1.690～12.390)、亲友病故(OR=2.555,95%CI:1.475～4.424)、睡觉戴文胸(OR=1.902,95%CI:1.177～3.072)、常吃肥肉(OR=2.709,95%CI:1.546～4.749)和腌制品(OR=2.460,95%CI:1.300～4.653);保护因素有:装修用环保材料(OR=0.517,95%CI:0.339～0.789)、工作单位性质(OR=0.430,95%CI:0.243～0.762)、哺乳数(OR=0.109,95%CI:0.013～0.896)、充足的睡眠时间(OR=0.424,95%CI:0.205～0.880)。结论:浙江地区女性乳腺癌危险因素中,遗传、精神心理、生育、个人习惯、环境、饮食等相关因素起着重要作用,乳腺癌的发生和发展是多种因素作用的结果,因此需要采取综合措施才能有效控制乳腺癌。

Objective： To investigate the risk factors on female breast cancer in Zhejiang province.Methods： A case-control study was conducted in 200 cases of female breast cancer with histopathological diagnosis and 200 matched controls from Zhejiang province.Results： Univariate conditional logistic regression showed that family history of malignant tumor and breast cancer,housing decoration in last 10 years,mammary hyperplasia,adverse life events,bra with steel rings,sleeping with bra,high fat and pickle intake,poor sleep were positively related to breast cancer;whereas environmental friendly decoration materials,long decoration time interval,workplace condition,more lactation and parity,high fruits intake,sufficient sleep were negatively related to breast cancer.Multivariate conditional logistic regression analysis showed that the risk factors included family history of other tumors [odds ratio（OR）= 1.571,95% confidence interval（CI）：1.029-2.396],mammary hyperplasia（OR=3.066,95%CI：1.834-5.126）,job-related life events（OR=4.575,95%CI：1.690-12.390）,the death of a loved one（OR=2.555,95%CI：1.475-4.424）,wearing bra at night（OR=1.902,95%CI：1.177-3.072）,high fat intake（OR=2.709,95%CI：1.546-4.749） and salted food（OR=2.460,95%CI：1.300-4.653）.Factors as environmental friendly decoration materials（OR=0.517,95%CI：0.339-0.789）,workplaces condition（OR=0.430,95%CI：0.243-0.762）,more lactation（OR=0.109,95%CI：0.013-0.896）,enough sleep（OR=0.424,95%CI：0.205-0.880） were protective factors.Conclusion： Hereditary,psychological factors,lifestyle,environment and diet related factors are significantly associated with risk of breast cancer.