广州地区肺癌的病例-对照研究

Case-Control Study of Human Lung Cancers in Guangzhou

目的 :探讨广州地区人群发生肺癌的危险因素。方法 :将 1 998- 2 0 0 1年新诊断的原发性肺癌病例 4 45例按性别、年龄 1∶1配对选取 4 45例健康者进行对照研究、问卷调查、建立数据库、单因素分析和多因素条件Logistic回归分析 ,筛选肺癌的主要危险因素。结果 :单因素分析发现 32个暴露因素与肺癌发生有关 ;多因素分析发现肺癌有 9个主要危险因素和 1个保护因素 ,他们是 :1 )吸烟OR及 95 %CI为 3 1 9(2 1 8～ 4 6 7) ;2 )被动吸烟来源于父亲OR为 2 4 3(1 5 1～ 3 90 ) ;3)被动吸烟来源于配偶OR为2 33(1 2 6～ 4 30 ) ;4 )肺结核病史OR为 2 36 (1 1 3～ 4 94 ) ;5 )家庭用煤为燃料OR为 3 4 4 (1 38～8 5 7) ;6 )常食用腌、酸菜OR为 3 83(2 34～ 6 2 7) ;7)常食用咸鱼OR为 4 4 9(2 86～ 7 0 6 ) ;8)经常下厨用猛火炒菜OR为 4 4 5 (3 0 3～ 6 5 6 ) ;9)职业接触金属类毒物OR为 8 76 (2 2 8～ 33 6 4)。 1 0 )经常体育锻炼OR为 0 5 9(0 33～ 1 0 6 ) ,可能是一个候选的保护因素。结论 :肺癌的发生与多种暴露因素有关 ,从其病因学来看 。

Objective To investigate the risk factors of human lung cancers in Guangzhou.Methods Four hundred and forty five newly diagnosed primary lung cancer cases and equal number of controls,matched for age and sex,were enrolled and interviewed in Guangzhou between 1998 and 2001.The questionnaire consists of 245 items about the aetiological factors of lung cancers.The data base was set up,and statistical analysis of single factor and multivariate conditional Logistic regression were performed by SAS 8 0 software.Results By using single factor analysis,32 exposure factors were identified as aetiological factors for lung cancer.Multivariate conditional Logistic regression analysis showed 9 main risk factors and 1 protective factor for lung cancers.There were:smoking with odds ratio (OR) 3 19 (95%CI 2 18-4.67),exposure to environmental tobacco smoke (ETS) from father with OR 2 43 (95%CI 1 51-3 90),exposure to ETS from spouse with OR 2 33(95%CI 1 26-4 30),history of lung tuberculosis with OR 2 36 (95%CI 1 13-4 94),coal fuel usage with OR 3 44 (95%CI 1 38-8 57),eating pickled vegetable with OR 3 83 (95%CI 2 34-6 27),eating pickled and salted fish with OR 4 49 (95%CI 2 86-7 06),cooking practice by strong fire with OR 4 45 (95%CI 3 03-6 56),occupational exposure to metal poisons with OR 8 76 (95%CI 2 28-33 64),and physical exercises might be a protective factor with OR 0 59 (95%CI 0 33-1 06).Conclusions From the aetiololgical study,the development of human lung cancer must be connected with many environmental exposures,and lung cancer is a preventable disease.