Glutathione S-transferases M1,T1 genotypes and the risk of gastric cancer:A case-control study

AIM Glutathione S-transferases (GSTs are involved in the detoxification of many potential carcinogens and appear to play a critical role in the protection from the effects of carcinogens. The contribution of glutathione Stransferases M1 and T1 genotypes to susceptibility to the risk of gastric cancer and their interaction with cigarette smoking are still unclear. The aim of this study was to determine whether there was any relationship between genetic polymorphisms of GSTM1 and GSTT1 and gastric cancer.METHODS A population based case - control study was carried out in a high-risk area, Changle County, Fujian Province, China. The epidemiological data were collected by a standard questionnaire and blood samples were obtained from 95 incidence gastric cancer cases and 94 healthy controls. A polymerase chain reaction method was used to detect the presence or absence of the GSTM1 and GSTT1 genes in genomic DNA. Logistic regression model was employed in the data analysis.RESULTS An increase in risk for gastric cancer was found among carriers of GSTM1 null genotype. The adjusted odds ratio (OR) was 2.63 [95% Confidence Interval (95% CI) 1.17-5.88], after controlling for age,gender, cigarette smoking, alcohol drinking, and fish sauce intake. The frequency of GSTT1 null genotype in cancer cases (43.16%) was not significantly different from that in controls (50.00%). However, the risk for gastric cancer in those with GSTM1 null and GSTT1 nonnull genotype was significantly higher than in those with both GSTM1 and GSTT1 non-null genotype (OR = 2.77,95% Cl 1.15- 6.77). Compared with those subjects who never smoked and had normal GSTM1 genotype, Ors were 1.60 (95% CI: 0.62- 4.19) for never smokers with GSTM1 null type, 2.33 (95% CI 0.88- 6.28) for smokers with normal GSTM1, and 8.06 (95% CI 2.83- 23.67) for smokers with GSTM1 null type.CONCLUSIONS GSTM1 gene polymorphisms may be associated with genetic susceptibility of stomach cancer and may modulate tobacco-related carcinogenesis of gastric cancer.

Diet and gastric cancer:a case-control study in Fujian Province,China

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Helicobacter pylori infection and risk of gastric cancer in Changle County,Fujian Province,China

AIM To evaluate the effects of Helicobacterpylori infection and other environmental factorson the development of gastric cancer.METHODS A population-based case-controlstudy was conducted in Changle County,FujianProvince.The primary gastric cancer cases werehistologically confirmed or diagnosed by surgerybetween,January 1996 and March 1998.Healthycontrols were randomly selected and matched byage,sex,and neighborhood of residence.Atotal of 101 pairs were included in the study.Specially trained interviewers conducted face-to-face interviews with the subjects according toa standardized questionnaire.Helicobacterpylori infections were measured by serum IgGantibody to Helicobacter pylori.ConditionalLogistic Regression analysis was used.RESULTS The presence of IgG antibody toHelicobacter pylori was 63.7% in studysubjects,56.0% in patients with cardiac cancer,and 60.5% in patients with non-cardiac gastriccancer.The risk factors of gastric cancer inChangle County were identified such as loweducational level[OR=3.864;95% confidenceinterval(95% CI)1.604-9.311],lowconsumption of fresh vegetables(OR=4.925;95%Cl 1.356-17.885),high intake of fish sauce(OR=10.587;95% Cl 2.821-39.738),unscheduled meals(OR=4.254;95%Cl 1.445- 12.552),and Helicobacter pylori infection(OR=3.453;95%Cl 0.901-13.224).CONCLUSION Helicobacter pylori infectionmay be important in the etiology of gastriccancer,but major risk factors other thanHelicobacter pylori are responsible for the highgastric morbidity in Changle County.

Fish sauce and gastric cancer:an ecological study in Fujian Province,China

AIM To explore the relationship betweenconsumption of fish sauce and the risk of gastriccancer in Fujian Province.METHODS An ecological study was carriedout.A total of 11000 subjects from 55 townshipswere randomly selected from 10 counties withinFujian Province.All subjects were localresidents who had been living in Fujian Provincefor more than 20 years,within the age group of45-74 years.Trained interviewers conductedface-to-face interviews with a standardizedquestionnaire,which covered the frequency andamount of food intake,dietary habit,tobaccoand alcohol consumption and history of chronicgastric diseases.Univariate and multivariateanalyses were performed using Epi-info and SASstatistical packages,respectively.RESULTS A significant correlation betweenmonthly consumption of fish sauce and mortalityof gastric cancer was found.Pearson’scoefficient of correlation was statisticallysignificant with r=0.7356 for males,r=0.5246for females(P【0.01).In the multivariateanalysis,consumption of fish sauce still showedan association with the risk of gastric cancer.No significant positive correlation betweenesophagus cancer,liver cancer,colon cancerand consumption of fish sauce were observed.CONCLUSION Long-term intake of fish saucemay be related to high mortality of gastriccancer.Consumption of fish sauce might be oneof important and unique etiologic factors ofgastric cancer in Fujian Province.Furtherstudies are needed to confirm this ecologicalstudy.

Relationship between different sources of drinking water,water quality improvement and gastric cancer mortality in Changle County--A retrospectivecohort study in high incidence area

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Sex as an effect modifier in the association between alcohol intake and gastric cancer risk

BACKGROUND The results of previous meta-analyses evaluating the association between the alcohol intake and gastric cancer risk have reported that a statistical significance only for men.AIM To investigate the different association between alcohol intake and gastric cancer risk between men and women.METHODS The selection criteria included a prospective cohort study for evaluating alcohol intake and gastric cancer risk,with relative risks adjusted for potential confounders.Adjusted relative risk(RR)for the potential confounders and its 95%confidence interval(CI)in the highest vs lowest level were extracted from each study and a random-effects meta-analysis was conducted.Subgroup analyses by region,level of adjustment for smoking status,adjusting for body mass index,and year of publication were conducted.RESULTS A meta-analysis of all 27 cohorts showed that alcohol intake increased the risk of gastric cancer(summary RR=1.13,95%CI:1.04-1.23,I2=58.2%).Further,13 men’s cohorts had higher summary RR while maintaining statistical significance,and only seven women’s cohorts had no statistical significance.CONCLUSION The present review suggests that alcohol consumption increases the risk of gastric cancer in men.These findings showed that the sex variable in the association between alcohol intake and gastric cancer risk seemed to be an effect modifier with an interaction term.It is necessary to re-estimate follow-up outcomes after stratifying for sex.

Human papillomavirus infection and gastric cancer risk: A metaepidemiological review

Gastric cancer(GC)is a multifactorial disease,and several modifiable risk factors have been reported.This review summarizes and interprets two previous quantitative systematic reviews evaluating the association between human papillomavirus(HPV)infection and GC risk.The results of two systematic reviews evaluating the same hypothesis showed a statistically significant difference in summary odds ratios and their 95%confidence intervals.Thus,it is necessary to conduct a subgroup analysis of Chinese and non-Chinese studies.Additional meta-analyses that control for heterogeneity are required.Reanalysis showed that all the Chinese studies had statistical significance,whereas the nonnational studies did not.The funnel plot asymmetry and Egger's test confirmed publication bias in the Chinese studies.In addition,the proportion of HPVpositive cases in Chinese studies was 1.43 times higher than that in non-Chinese studies and 2.81 times lower in controls.Therefore,the deduced evidence is currently insufficient to conclude that HPV infection is associated with GC risk.

生活习惯和饮食与胃癌发生的相关性研究

目的:探讨生活习惯和饮食等危险因素与胃癌发生的关系。方法:采用病例对照研究,胃癌患者97例,非胃癌肿瘤患者77例为对照组,调查患者的一般情况、既往史及家族史、饮食摄入情况、生活居住环境以及饮酒和吸烟史等,饮食部分的调查采用频数法。对资料进行单因素和多因素非条件Logistic回归分析。结果:单因素分析结果,饮酒、吸烟年限长、有胃癌家族史和喜吃腌制食物是胃癌的危险因素,OR值分别为2.456、2.333、3.060和1.959;清淡、酸性食物、喝绿茶和喝茶年限超过20年是胃癌的保护性因素,OR值分别为0.402、0.297、0.402和0.331;多因素分析结果,腌制食物、吸烟年限长、胃癌家族史是胃癌的危险因素,而清淡饮食和喝茶年限长是胃癌的保护性因素。结论:腌制食物、吸烟年限长和胃癌家族史可增加胃癌的发病风险,而清淡饮食和喝茶年限长可降低胃癌发生的危险性。

上消化道肿瘤高发区胃癌、食管癌病例对照研究

目的 探索泰兴市胃癌、食管癌的高危因素。方法 选择 1998年 9月 1日～ 1999年 12月 31日期间 430例胃癌和 5 91例食管癌新发病例 ,按年龄、性别和居住地进行以人群为基础 1∶1配对的病例对照研究。分别采用Epi info(6 0 4版 )和SAS(6 12版 )统计软件进行单因素和多因素分析。结果 单因素分析发现 ,经济状况差、吸烟、进食速度快、三餐不按时和既往患胃炎和胃溃疡 ,以及平时经常忧郁、长期处于精神压抑状态是泰兴地区胃和食管癌的共同危险因素。而有良好的人际关系、黄绿蔬菜的大量摄入 ,则可降低两种癌症的危险性。而饮高度白酒 (OR =2 71)、口味嗜咸(OR =1 42 )、喜爱吃烫食 (OR =2 2 1)、食管病变 (OR =6 6 2 )和一级亲属中有人患食管癌 (OR =1 98)是食管癌的危险因素 ,多吃水果 (OR =0 6 8)则可降低患胃癌的危险性。多因素条件Logistic回归分析结果显示 ,既往有胃、食管病变、平时经常忧郁是胃、食管癌共同危险因素。进食速度快、三餐不按时、喜食烫食、过量饮高度白酒、一级亲属中有人患食管癌均作为食管癌的危险因素 ,而经常摄入黄绿蔬菜则作为胃癌保护因素进入回归方程。结论 精神因素。

以人群为基础子宫肌瘤危险因素病例对照研究

目的：探讨妇女子宫肌瘤的患病情况及其危险因素。方法：采用分层随机抽样的方法对沈阳地区1260名女性的子宫肌瘤患病状况进行问卷调查,对113例病例采用1∶2配比病例对照研究方法,探讨子宫肌瘤危险因素。结果：子宫肌瘤患病率为8.97%（113/1 260）,其中40-49岁组的患病率最高为15.29%（65/425）;影响子宫肌瘤发生的危险因素按危险性大小依次为月经紊乱、既往盆腔炎、既往宫颈炎、口服避孕药、既往阴道炎和人工流产史,而月经初潮年龄延迟可能是子宫肌瘤的保护因素。结论：子宫肌瘤发病与月经紊乱、既往盆腔炎、既往宫颈炎、既往阴道炎、口服避孕药和人工流产史有关。有必要针对各种危险因素加强女性健康教育,提高其生殖健康水平。

泰兴市全人群肝癌病例对照研究

[目的]探讨泰兴市原发性肝癌的病因。[方法]选择360例原发性肝癌新发病例按性别、年龄和居住地进行以人群为基础1∶1配对的病例对照研究。[结果]单因素分析结果表明 ,饮沟塘水、饮酒量多、不良精神因素(受过强烈精神刺激、长期处于精神压抑状态和性格忧郁)、HBsAg阳性、肝脏病变(慢性肝炎、肝硬化)、家族肝癌史(父母、兄弟姐妹患肝癌)会增加泰兴市居民患肝癌的危险性。多因素条件Logistic回归分析结果显示 ,HBsAg阳性、慢性肝炎、肝硬化、一级亲属患肝癌和饮小麦酒量多均进入回归方程 ,其相对危险度分别为20 80、13 41、5 24、3 23和5 73。

ABO血型与胃癌发生风险的病例-对照研究及meta分析

目的通过病例一对照研究及meta分析探讨ABO血型系统与胃癌发生风险的关系。方法收集第二军医大学长海医院930例胃癌患者及8426例非胃癌患者进行病例一对照研究；检索PubMed数据库，检索起始时间不限，截止时间为2013年12月31日。将笔者所做病例一对照研究一并纳入分析，由2名研究者独立筛取文献并提取数据，采用纽卡斯尔-渥太华量表（NOS）进行文献质量评价，采用Meta—Analyst3．13软件进行meta分析。结果病例对照研究提示：血型A是胃癌发生的可能危险因素（OR=1．58，95％CI为1．37～1．81）；meta分析结果显示：血型A较非A血型人群胃癌发生风险有所增加（0R=1．28，95％CI为1．01～1．62），血型O发生胃癌风险低于非O血型人群（OR=0．84，95％CI为0．73～0．96），但亚组分析发现结果在国内外人群中存在差异。结论ABO血型系统与胃癌发生风险存在关联，血型A是胃癌发生的可能危险因素之一。

江苏省大丰市胃癌危险因素病例对照研究

[目的]探讨大丰市与胃癌发病有关的危险因素。[方法]选择大丰市进行以人群为基础的胃癌1∶1配对病例对照研究,共调查胃癌病例和对照各649例,配成对数649对。结果采用单因素及多因素条件Logistic回归方法进行分析。[结果]A型血(OR=3.127,95%CI:1.488～6.571),进食速度快(OR=3.587,95%CI:2.570～5.006),喜食咸(OR=2.703,95%CI:1.261～5.794)或烫(OR=3.445,95%CI:2.526～4.697)食品,性格忧郁(OR=2.512,95%CI:1.333～6.819)等为大丰市胃癌发病的主要危险因素,而粮食储具常清洗翻晒(OR=0.054,95%CI:0.004～0.815),喜食大蒜(OR=0.337,95%CI:0.048～0.651),常食用新鲜蔬菜(OR=0.488,95%CI:0.274～0.869)等则为其保护因素。[结论]应当通过教育居民改变不良的生活饮食习惯、注意心理精神卫生以降低胃癌发病危险性。

广州地区肺癌的病例-对照研究

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 。

赣榆县胃癌影响因素1:1配对病例对照研究

目的探讨赣榆县胃癌危险因素及保护因素,为该地区胃癌防治工作提供依据。方法对319例新发胃癌病例及其1:1配对的健康对照者进行相关因素调查,应用条件Logistic回归对相关因素进行分析。结果胃癌的主要危险因素为进食热烫食物(OR=2.21,95%CI:1.57～3.12)、上消化道炎症患病史(OR=4.26,95%CI:2.59～7.03)、癌症家族史(OR=2.29,95%CI:1.37～3.82);主要保护因素为经常生吃大蒜(OR=0.64,95%CI:0.42～0.96)、经常饮茶(OR=0.37,95%CI:0.25～0.54)。结论胃癌的发病与不良的膳食习惯、上消化道炎症及癌症家族史有关,生吃大蒜和饮茶能有效预防胃癌的发生。

磁县胃癌危险因素病例对照研究

目的 探讨胃癌发病的危险因素。方法 选磁县肿瘤防治所登记的肿瘤发病资料中的 370例胃癌患者做 1∶1比例对照研究。结果 饮食软硬适中OR =0 54,常吃大蒜OR =0 72 5,10年前饮用山泉水OR =32 166,低体质指数OR =2 173,婚烟生活OR =2 673,10年前食用水果OR =0 538,10年前食用杂粮OR =0 691,精神创伤OR =11 891,有胃溃疡病史OR =39 2 62 ,做菜喜用煮OR =0 50 4 ,有浅表性胃炎OR =2 1 753。结论 过去饮用山泉水、低体质指数、婚姻生活不和谐、有精神创伤、有胃溃疡病史及浅表性胃炎病史为胃癌的危险因素 ;而饮食饮硬适中、食用大蒜、过去食用水果较多、过去食用杂粮较多及烹调喜用煮的方式为胃癌的保护因素。

早期胃癌淋巴结转移的临床病理特征分析

背景:淋巴结转移是影响早期胃癌(EGC)预后的首要因素。目的:探讨EGC淋巴结转移的危险因素,为制定合理的治疗方案提供临床依据。方法:回顾性分析南京鼓楼医院2002年9月～2008年12月经手术病理证实的250例EGC患者,分别采用单因素和多因素分析探讨性别、年龄、肿瘤大小、肿瘤部位、大体类型、溃疡、组织学类型、浸润深度、淋巴管肿瘤浸润以及神经侵犯与淋巴结转移的关系。结果:EGC淋巴结转移率达14.0%。单因素分析显示性别、肿瘤大小、浸润深度、淋巴管肿瘤浸润和神经侵犯与EGC淋巴结转移相关(P<0.05)。多因素分析显示女性、肿瘤大小(>2 cm)、黏膜下层浸润和淋巴管肿瘤浸润是EGC淋巴结转移的独立危险因素(P<0.05)。在肿瘤直径≤2 cm且分化良好的黏膜内EGC患者中未发现淋巴结转移。结论:评估EGC淋巴结转移与临床病理特征的关系具有重要的临床意义。肿瘤直径≤2 cm且分化良好的黏膜内EGC可行内镜治疗。

上海市区饮食与胃癌发病的病例对照研究

背景:近30年来上海市区胃癌发病率已明显下降。1972～1999年,男性和女性胃癌的年龄调整发病率分別从62.0/10万和23.9/10万降至35.8/10万和17.5/10万。目的:研究环境因素,尤其是饮食因素与居住在上海市区15年以上的居民胃癌发病的关系,以探讨近30年来上海市区胃癌发病率逐渐下降的原因。方法:采用统一饮食频度问卷调查189例胃癌患者和567名对照人群,调查内容包括一般情况、胃癌发病前5年和10年的住房和收入状况、饮食和生活习惯、冰箱使用、吸烟和饮酒史、既往胃病史、肿瘤家族史等。采用SPSS软件包进行单因素和多因素非条件Logistic回归分析。结果:常服维生素、使用冰箱储存食物、多食新鲜水果、蔬菜、豆、奶制品和良好的饮食习惯等为预防胃癌的保护因素;肿瘤家族史、慢性胃病史、多食煎炸、盐渍、腌晒、烟熏食品、不良饮食习惯、吸烟、饮白酒等为发生胃癌的危险因素。结论:近30年来上海市区居民胃癌发病率的下降与环境因素,特别是饮食因素和广泛使用冰箱密切相关。

江苏省经济发达与发展中地区胃癌危险因素对比研究

[目的]探索江苏省经济发达地区与经济发展中地区胃癌危险因素。[方法]分别选择常熟市(GDP64931RMB/人)和泰兴市(GDP13512RMB/人)常住户口且确诊为胃癌的男性病人202例和200例,对照选取与病例同性别、年龄±2岁,与病例居住在同地的非肿瘤居民,按1∶1配对进行病例对照研究。[结果]多因素分析发现,吃饭速度快、吃新鲜蔬菜少、胃溃疡和萎缩性胃炎是泰兴市和常熟市胃癌的共同危险因素;而三餐不按时、吃咸鱼咸肉多是常熟市胃癌危险因素;十年前家庭人均收入低、人际关系不好、吃油炸食品多、口味咸、性格内向是泰兴市胃癌危险因素。[结论]在全省对上述普遍存在的高危因素进行广泛地卫生宣教,以减少胃癌危害性。

回族血清中微量元素含量与胃癌的相关性研究

目的探讨回族血清中微量元素含量与胃癌的关系。方法采用原子吸收分光光度法对回族胃癌患者和回族非胃癌对照人群血清中锌(Zn)、铜(Cu)、铁(Fe)、镁(Mg)、钙(Ca)、锰(Mn)、镍(Ni)元素含量进行检测,并用SPSS统计软件对实验结果进行配对t检验分析。结果回族胃癌病例组血清中Cu、Cu/Zn、Mn均比对照组高,而Zn、Fe、Ca、Mg、Ni的含量低于对照组。配对t检验结果显示,血清中Cu、Zn、Cu/Zn、Ca、Mg含量差异有统计学意义(P<0.05)。结论回族胃癌的发生、发展与血清内微量元素变化密切相关。高Cu、Cu/Zn比值高以及低Zn、低Ca、低Mg是回族胃癌发生的危险因素。