油炸食品摄入与胃癌及癌前病变的相关因素分析

Multivariate analysis of the association between consumption of fried food and gastric cancer and precancerous lesions

目的探讨油炸食品摄入与胃癌及癌前病变发病的相关因素。方法以2005—2013年在河南省农村地区开展上消化道癌症筛查项目的11个行政县/市的40～69岁居民共82 367名为研究对象，收集人口学、生活方式、油炸食品摄入频率信息，进行内镜筛查并取活检组织进行病理诊断，依据病理诊断标准将其分为不同病变等级，并采用多元有序logistic回归分析油炸食品摄入频率与胃癌及癌前病变发病的相关因素。结果最终有82 367名调查对象参加内镜筛查，年龄为（53.46±8.07）岁，男性和女性分别为46 425名和35 942名。检测到胃正常患者6 707名，低级别上皮内肿瘤2 325例，高级别上皮内肿瘤226例，胃癌331例。多因素有序logistic回归分析结果表明，在调整了年龄、性别、婚姻状况、文化程度、BMI、吸烟和饮酒状况后，油炸食品与胃癌及癌前病变发病相关，与油炸食品摄入频率〈1次/周相比，食用频率1～2次/周时，胃癌及癌前病变发病的OR值为1.89（95%CI：1.57～2.28）；当油炸食品摄入频率≥2次/周时，其OR值为1.91（95%CI：1.66～2.20）。结论油炸食品摄入频率≥2次/周是胃癌及癌前病变发病的相关因素，减少油炸食品摄入可预防胃癌及癌前病变的发生。

Objective To investigate the effect of fried food intake on the pathogenesis of gastric cancer and precancerous lesions.Methods From 2005 to 2013, the residents aged 40-69 years from 11 counties/cities where cancer screening of upper gastrointestinal cancer were conducted in rural areas of Henan province as the subjects （82 367 cases）. The information such as demography and lifestyle was collected. The residents were screened with endoscopic examination. The biopsy sampleswere diagnosed pathologically, according to pathological diagnosis criteria, the subjects with high risk were divided into the groups with different pathological degrees. The multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and gastric cancer and precancerous lesions.Results The study coverd 46 425 males and 35 942 females, with a age of （53.46±8.07）years. The study collected 6 707 cases of normal stomach, 2 325 cases of low grade intraepithelial neoplasia, 226 cases of high grade intraepithelial neoplasia and 331 cases of gastric cancer. Multivariate logistic regression analysis showed that, compared with those whoeat fried food less than one time per week, fried foods intake （〈2 times/week： OR=1.89, 95%CI： 1.57-2.28; ≥ 2 times/week： OR=1.91, 95%CI： 1.66-2.20） were a risk factor for gastric cancer and precancerous lesions after adjustment for age, sex, marital status, educational level, body mass index （BMI）, smoking and drinking status.Conclusion The intake of fried food is a risk factor for gastric cancer and precancerous lesions. Therefore, reducing the intake of fried food can prevent the occurrence of gastric carcinoma and precancerous lesions.