武汉地区女性乳腺癌危险因素的病例对照研究

A case--control study on the risk of female breast cancer in Wuhan area

目的 探讨武汉地区女性乳腺癌的危险因素及其变化情况。方法 以病例对照研究方法,对经病理确诊的213例乳腺癌患者及430例匹配对照进行危险因素的条件logistic回归分析。结果 单因素分析显示:文化程度、乳腺良性肿瘤、初潮年龄、绝经年龄、肉类摄入量、油炸烧烤食物摄入、豆类食品摄入、水果摄入、哺乳时间。体重指数、10～19岁胸透次数、精神心理因素等28项因素与乳腺癌的危险性有关。联合多因素及分组多因素条件1ogistic回归分析显示:文化程度高、精神创伤、乳腺良性肿瘤史、绝经晚、行经年数和初产前行经年数长、体重指数高、常食油炸烧烤和烟熏腊制食物为乳腺癌的危险因素;初潮晚、哺乳时间长、豆类或水果摄入量高、常饮茶为保护因素。绝经前与绝经后的危险因素种类及效应强度有一定差别。经多因素分析,绝经前主要相关因素为乳腺良性肿瘤、初潮年龄、豆类摄入量;绝经后主要与绝经年龄、体重指数、腰臀比和水果摄入量有关。另外,精神创伤及哺乳时间为绝经前后共同的危险因素和保护因素。结论 武汉地区女性乳腺癌危险因素中,饮食习惯和内源性雌激素暴露等相关因素起着重要作用。

Objective To investigate the risk factors of female breast cancer and its potential alteration in Wuhan area. Methods A case-control study was conducted on 213 cases with histopathological diagnosis and 430 matched controls, using conditional logistic regression analysis. Results 28 factors such as educational level, history of benign breat disease, age at menarche, age at menopausal, meat and well-done meat intake, soy bean food, fruit, lactation time, body mass index (BMI), juvenile chest X-ray, psychological factor, were associated with breast cancer risk in one-way variance model. Multivariate conditional logistic regression analysis in total significant factors and subgroups showed that the risk factors of breast cancer would include high level education, psychological trauma, history of benign breast disease later age at menopause, more years of menstrual and more years of menstrual before giving first birth, high BMI, well--done meat intake and smoked food. Factors as later menarche, lactate longer, soybean food, fruit, drink tea habit were protective factors for breast cancer. Further breakdown of data showed some difference between premenopausal and postmenopausal women. Risks in premenopausal women were associated with history of benign breast disease, age of menarche, soybean food intake, whereas risks in postmenopausal women were related to age of menopausal, BMI, waist-hip ratio and fruit intake. Both psychological traumatic and duration of lactation were common pre- and postmenopausal risk and protective factors. Conclusions Dietary habit and endogenous estrogen exposure related factors played important roles on women breast cancer in Wuhan area.