乳头状甲状腺癌患病影响因素病例对照研究

Influencing factors of papillary thyroid carcinoma:a case-control study

目的 了解乳头状甲状腺癌患病的影响因素,为相应防治策略的制定提供科学依据。方法 采用以医院为基础1∶2配对病例对照研究方法对2013年4月—2014年6月在福建省肿瘤医院收治的123例乳头状甲状腺癌患者及同期在该医院进行健康体检的246名体检人群进行问卷调查。结果 病例组患者体质指数〉25.0 kg/m2、被动吸烟1~2天/周、被动吸烟≥3天/周、染发1~2次/年、染发≥3次/年、食油炸食品〉5次/周、食十字花科植物〉5次/周、CT检查≥3次、压力大、一级亲属甲状腺癌患者1例、一级亲属甲状腺癌患者≥2例的比例分别为14.63%、54.47%、33.33%、62.60%、4.88%、28.46%、50.41%、12.20%、20.33%、9.76%、6.50%,均高于对照组体检人群的6.10%、46.34%、19.92%、42.28%、2.03%、15.85%、33.74%、5.69%、10.57%、1.63%、1.22%,病例组患者锻炼1~2次/周的比例为10.57%,低于对照组体检人群的21.54%,差异均有统计学意义（均P〈0.05）;多因素条件logistic回归分析结果显示,体质指数〉25.0 kg/m2、被动吸烟≥1天/周、染发≥1次/年、CT检查≥3次、压力大、一级亲属甲状腺癌患者≥1例是乳头状甲状腺癌患病的危险因素,锻炼1~2次/周是乳头状甲状腺癌患病的保护因素。结论 体质指数、被动吸烟、染发、CT检查、压力情况、一级亲属甲状腺癌患病情况、锻炼情况是乳头状甲状腺癌患病的主要影响因素。

Objective To explore influencing factors of papillary thyroid carcinoma for making strategies for the prevention of the disease. Methods A 1 ： 2 matched hospital-based case-control questionnaire study was carried out among 123 papillary thyroid carcinoma patients receiving surgery in Fujian Provincial Tumor Hospital between April 2013 through June 2014 and 246 controls having health examination at the hospital during the same period. Results Compared to those of the controls, the cases had significantly higher proportions for with the body mass index （BMI） 〉 25.0 kg/m2 （ 14.63% vs. 6.10% ） ,time of second-hand smoking （54. 47% vs. 46. 34% for 1 - 2 day/week,33.33% vs. 19. 92% for ≥3 day/week）, frequency of hair dying （62. 60% vs. 42. 28% for 1 - 2 times/year, 4. 88% vs. 2.03% for ≥ 3 times/year）, eating fried food 〉 5 times/week （ 28.46% vs. 15.85 % ）, eating cruciferous vegetables 〉 5 times/week （50.41% vs. 33.74% ）, having computed tomography （CT） ≥ 3 times （ 12. 20% vs. 5.69% ）, with high stress （20. 33% vs. 10. 57% ） ,with his or her first degree relative having history of thyroid cancer （9. 76% vs. 1.63% for one relative,6. 50% vs. 1.22% for two or more relatives）, respectively, and lower proportion for having physical exercise 1 -2 times/week （10. 57% vs 21.54% ） （P 〈 0. 05 for all）. Multivariate conditional logistical regression analysis indicated that BMI ≥ 25 kg/m2 , second-hand smoking ≥1 day/week, hair dying ≥1 time/year, having CT ≥ 3 times, having high stress, and having first degree relative with thyroid cancer history were risk factors of papillary thyroid carcinoma; while having physical exercise 1 - 2 times/week was a protective factors. Conclusion BMI, second-hand smoking, hair dying, CT examination, thyroid cancer history in first degree relative, stress and physical exercise were main influencing factors of papillary thyroid carcinoma.