肥城市居民胃癌及癌前病变危险因素分析

Analysis of risk factors of gastric cancer and precancerous lesions in Feicheng residents

目的探讨影响肥城市居民胃癌及癌前病变发病的危险因素,为肥城市胃癌及癌前病变防治提供有针对性的科学依据。方法选取2017-2019年在“国家胃癌早诊早治示范基地(肥城市)”参与胃癌筛查的40~69岁居民为研究对象。通过调查问卷收集研究对象的基本情况和生活方式等信息,利用“内镜下碘染色+指示性活检”技术对研究对象进行内镜筛查,利用单因素分析和多因素Logistic回归模型分析胃癌及癌前病变的危险因素。结果共纳入研究对象6403人,中位年龄54岁,男2310人(36.1%),女4093人(63.9%)。胃癌及癌前病变共检出180例,检出率为2.8%。多因素分析结果显示,女性(OR=0.61,95%CI为0.39~0.95)、已婚(OR=0.43,95%CI为0.27~0.68)和不吸烟(OR=0.55,95%CI为0.35~0.87)相比于男性、其他婚姻状况和吸烟者,发生胃癌及癌前病变的风险要小。与40~49岁和经常吃新鲜水果者相比,60~69岁(OR=1.59,95%CI为1.04~2.43)和从不吃新鲜水果者(OR=1.76,95%CI为1.18~2.62)发生胃癌及癌前病变的风险较大。结论性别、年龄、婚姻状况、吸烟情况和新鲜水果的摄入与肥城市胃癌及癌前病变的发病有关,改变不良生活方式有利于胃癌及癌前病变的预防。

Objective To investigate the risk factors of gastric cancer and precancerous lesions in Feicheng city,and to provide scientific basis for the prevention and treatment of gastric cancer and precancerous lesions in Feicheng.Methods The subjects were residents aged 40-69 years who participated in gastric cancer screening in the"National Demonstration Base for Early Diagnosis and Treatment of Gastric Cancer(Feicheng)"from 2017 to 2019.General information,lifestyle and other information of the subjects were collected through questionnaires.The endoscope iodine staining and indicative biopsy methods were used for cancer screening and pathologic diagnosis among eligible people,and the risk factors of gastric cancer and precancerous lesions were analyzed by univariate and multivariate Logistic regression models.Results A total of 6403 subjects were included,with an average age of(56.18±6.969)years old,including 2310 males(36.1%)and 4,093 females(63.9%).Totally 180 cases of gastric cancer and precancerous lesions were detected,with the detection rate of 2.8%.Multivariate Logistic regression model analyses showed that women(OR=0.61,95%CI:0.39-0.95),married people(OR=0.43,95%CI:0.27-0.68)and non-smokers(OR=0.55,95%CI:0.35-0.87)were less likely to develop gastric cancer and precancerous lesions than men,other marital status,smokers nespectively.The risk of gastric cancer and precancerous lesions was higher in people aged 60 to 69(OR=1.59,95%CI:1.04-2.43)who never ate fresh fruit(OR=1.76,95%CI:1.18-2.62)than in people aged 40 to 49 who often ate fresh fruit.Conclusions Gender,age,marital status,smoking,and intake of fresh fruit were related to the incidence of gastric cancer and precancerous lesions in Feicheng city.Thereby Changing bad lifestyle was beneficial to the prevention of gastric cancer and precancerous lesions.