中国华东地区人群胃癌癌前病变发病相关危险因素分析

Analysis of risk factors associated with precancerous lesion of gastric cancer in patients from eastern China: a comparative study

目的探讨各种危险因素与中国华东地区人群胃癌癌前病变发病风险的关系,为胃癌癌前病变的个体化预防提供科学依据。方法收集中国华东地区胃癌癌前病变501例,浅表性胃炎523例;对两组多种危险因素进行描述性对比分析。结果与浅表性胃炎组比较,胃癌癌前病变组中的H.pylori感染、食管癌家族史、胃癌家族史、慢性萎缩性胃炎家族史、家族性腺瘤性息肉病、慢性萎缩性胃炎个人史、胃溃疡个人史、阿司匹林等非甾体抗炎药的使用、胃食管反流病、饮酒、亚硝基化合物饮食、不吃早餐三餐不定时、经常食用烟熏炙烤肉类食品、经常食用煎炸食品、经常食用辛辣食品、焦虑及抑郁的构成比,差异有统计学意义(P<0.05)。与胃癌癌前病变相关的危险因素分析依次是慢性萎缩性胃炎个人史、家族性腺瘤性息肉病、胃癌家族史、阿司匹林等非甾体抗炎药的使用、经常食用辛辣食品、H.pylori感染、家族食管癌史、饮酒、焦虑、胃溃疡个人史、胃食管反流病、慢性萎缩性胃炎家族史。结论对于中国华东地区来说,慢性萎缩性胃炎个人史是胃癌癌前病变最突出的危险因素,其次为家族性腺瘤性息肉病和胃癌家族史。

Objective To investigate the association between various risk factors and precancerous lesion of gastric cancer （PLGC） from eastern China. Methods 501 cases of PLGC and 523 cases of superficial gastritis were included. A comparative study between different risk factors and PGLC was performed. Results There were statistical differences in a series of indexes including Helicobacter pylori （H. pylori） infection, family history of esophageal cancer （EC） , gastric cancer （GC） and chronic atrophic gastritis （CAG）, personal history of CAG, gastric polyps （GP） and gastric ulcer （GU）, usage of non-steroids （aspirin）, gastroesophageal reflux disease （GERD）, drinking alcohol, eating food rich in nitroso compounds, irregular eating habits with no breakfast, ingestion of smoked meat, fried food and spicy food, anxiety and depression between PLGC and superficial gastritis groups. The risk factors associated with PLGC ranked in an order of personal history of CAG, GP, family history of GC, usage of non-steroids （aspirin） , ingestion of spicy food frequently, personal infection with H. pylori, family history of EC, drinking alcohol, anxiety, personal history of GU, GERD and family history of CAG. Conclusion Personal history of CAG was most associated with PLGC from eastern China, followed by personal history of GP and family history of GC.