上消化道肿瘤高发区胃癌、食管癌病例对照研究

A CASE-CONTROL STUDY OF ESOPHAGEAL AND STOMACH CANCERS IN HIGH INCIDENCE AREA OF UPPER-DIGESTIVE TRACT CANCER

目的 探索泰兴市胃癌、食管癌的高危因素。方法 选择 1998年 9月 1日～ 1999年 12月 31日期间 430例胃癌和 5 91例食管癌新发病例 ,按年龄、性别和居住地进行以人群为基础 1∶1配对的病例对照研究。分别采用Epi info(6 0 4版 )和SAS(6 12版 )统计软件进行单因素和多因素分析。结果 单因素分析发现 ,经济状况差、吸烟、进食速度快、三餐不按时和既往患胃炎和胃溃疡 ,以及平时经常忧郁、长期处于精神压抑状态是泰兴地区胃和食管癌的共同危险因素。而有良好的人际关系、黄绿蔬菜的大量摄入 ,则可降低两种癌症的危险性。而饮高度白酒 (OR =2 71)、口味嗜咸(OR =1 42 )、喜爱吃烫食 (OR =2 2 1)、食管病变 (OR =6 6 2 )和一级亲属中有人患食管癌 (OR =1 98)是食管癌的危险因素 ,多吃水果 (OR =0 6 8)则可降低患胃癌的危险性。多因素条件Logistic回归分析结果显示 ,既往有胃、食管病变、平时经常忧郁是胃、食管癌共同危险因素。进食速度快、三餐不按时、喜食烫食、过量饮高度白酒、一级亲属中有人患食管癌均作为食管癌的危险因素 ,而经常摄入黄绿蔬菜则作为胃癌保护因素进入回归方程。结论 精神因素。

Objective To study the risk and protective fators of esopha ge al cancer and stomach cancers in Taixing area. Methods Populati on-based case-control study was conducted in Taixing. It included 591 cases wi th esophageal cancer and 430 stomach cancer matched 1∶1 with normal population controls. Epi-info (6.04) and SAS (6.12) were used in data analysis. Re sults The results of single factor analysis indicated that poor economi c condition, smoking, irregular eating time, quick eating, long-term melancholy and feeling constrained, history of upper digestive tract illness were risk fact ors for both stomach and esophageal cancer, whereas good relationship with masse s and intake of fresh vegetables had protective effects. Large amount of alcohol consumption (OR=2.71), salty flavoring (OR=1.42), over-hot diet (OR=2.21), eso phageal illness (OR=6.62) and family history of esophageal cancer (OR=1.98) were risk factors for esophageal cancer. The results showed that intake of fruits (O R=0.68) can decrease risk for stomach cancer. Multiple conditional logistic regr ession analysis showed that long-term melancholy,history of upper digestive tra ct illness were risk factors for upper digestive tract cancer. Quick esting,irre gular eating time,over-hot diet, family history of esophageal cancer were risk factors for esophageal cancer, while fresh vegetable was a protective factor for stomach cancer. Conclusion The related pathological change of upper digestive tract and spiritual factors had significant effects on upper dig estive tract cancerization.