太原市肺癌病例对照研究

The case-control study of lung cancer in Taiyuan, China

【摘要】目的：通过病例对照研究探讨太原市不同类型肺癌的危险因素。方法：将由医院病理检查确诊的肺癌新发病例，配以人群为基础、随机选择的对照进行病例对照研究。完成调查表后，调整各类混杂因素，通过趋势检验和多因素非条件logistic回归分析各种危险因素与不同病理类型肺癌之间的关系。结果：吸烟仍是肺癌的主要危险因素，其危险度较高[比数比（oddsratio，DR）=3．75，95％可信区间（confidenceinterval，CI）：2．39～5．89]，其中肺鳞癌和小细胞肺癌的0四分别为5．01（95％CI：2．42～10．37）和5．06（95％CY：2．10～12．18）。肺癌与日均吸烟量、吸烟年数、累计吸烟量均有显著的剂量效应关系。工作和生活场所的被动吸烟及长期在厨房使用固体燃料烹饪和使用固体燃料取暖等室内污染因素在肺癌发生中起重要作用。空气颗粒物PM2．5（particulatematter2．5um）的研究刚刚开始，尚未发现室内颗粒物PM2．5的污染与肺癌有明显的关系。结论：对太原市居民而言，吸烟仍是肺癌的主要危险因素。被动吸烟和环境中的空气污染都不容忽视。

Objective： To investigate the risk factors of various types of lung cancer by case-control study in Taiyuan, China. Methods： In this case-control study, the incident lung cancer patients with pathological evidence came from hospitals and the randomly selected residents all over the city were chosen as the cases and the controls, respectively. After completion the survey by questionnaire, the trend test and multivariate unconditioned logistic regression analysis were used after adjusting the confounding variables. The relationship between various risk factors and different pathological types of lung cancer was analyzed. Results： Active smoking was the main risk of lung cancer and this risk factor was significant [OR （odds ratio）： 3.75, 95% CI （confidence interval）： 2.39-5.89], especially for squamous- cell lung cancer （OR： 5.01, 95% CI： 2.42-10.37） and small-cell lung cancer （OR： 5.06, 95% CI： 2.10-12.18）. There were significant linear trends of ORs for quantity of cigarettes consumed, duration of smoking and cumulative quantity of smoking. Various types of indoor air pollution such as passive smoking occurred in working and living places and long period of coal or wood use for cooking and heating were closely associated with the risk of lung cancer. The study on relationship between PM2.5 （particulate matter 2.5 IJm） and lung cancer is in startup stage, and no significant relationship was revealed. Conclusion： Smoking is still an important risk factor for lung cancer in Taiyuan, China. In addition, passive smoking and environmental air pollution also played an important role in development of lung cancer.