鞍钢工人的肿瘤危险度——肺癌病例-对照研究

对鞍钢男工中６１０例肺癌新发病例及９５９例对照进行了访问调查。经吸烟、其他肺疾患、家族肿瘤史、食用水果等非职业因素调整后，岗位工龄等于或超过１５年的下列工人的肺癌危险度显著增高：冶炼工和轧钢工（ＱＲ＝１．５，９５％ＣＩ＝１．１～２．２），耐火砖厂工（ＯＲ＝２．９，９５％ＣＩ＝１．４～５．９），装卸工（ＯＲ＝２．５，９５％ＣＩ＝１．０～６．１），焦炉工（ＯＲ＝３．４，９５％ＣＩ＝１．４～８．５）。各种粉尘和Ｂ［ａ］Ｐ暴露与肺癌危险性呈显著的剂量－反应关系，但与粉尘的特殊成分未见此种关联。长期暴露于污染物的钢铁工人的肺癌的危险度增加４０％。     

沈阳市女性肺癌危险因素的病例对照研究

对沈阳市区１９９１年４月至１９９４年１２月的３１３例、年龄３５～６９岁的女性肺癌患者进行了按年龄配比１：１的病例对照研究。结果显示，女性肺癌的危险因素为吸烟、烹饪油烟暴露，其ＯＲ值与９５％可信限分别为１．８６（１．３４～２．５７）和４．３１（３．０７～６．０５），其ＰＡＲ％分别为２２％与４６％。吸烟与油烟对肺癌的发生有交互作用，其相对超额危险度为３．１２。肺癌以腺癌为主，而吸烟仅与鳞癌有关。肺结核、慢性支气管炎增加肺癌发生危险性，但无显著意义。     

前列腺癌危险因素配比病例对照研究

为了解前列腺癌发病的影响因素对１３７例经组织病理学检查确诊的前列腺癌患者及其医院对照进行了１∶１配比调查，运用ＳＡＳ软件对资料进行统计学分析。单因素分析结果显示夫妻分居、肝病史、丧偶或离异、吸烟、饮酒、职业性毒物接触史是前列腺癌发病的危险因素；体力锻炼是一项保护性因素；多因素分析结果显示前列腺癌危险因素（比值比，９５％可信区间）有丧偶或离异（６．２９，２．０４—１９．３８）、肝病史（４．９０，１．３０—１８．４０）、夫妻分居（２．９１，１．３２—６．４１）；保护性因素有体力锻炼（０．３８，０．２０—０．７２）。     

影响低龄２型糖尿病发病因素的病例对照研究

摘要：目的　分析低龄２型糖尿病（ｄｉａｂｅｔｅｓｍｅｌｌｉｔｕｓｔｙｐｅ２,Ｔ２ＤＭ）发病的影响因素,为制定有针对性干 预策略和措施提供依据。方法　选取２０１６年７月１日至１１月３０日蚌埠医学院第一附属医院、蚌埠市第三 人民医院门诊及住院的Ｔ２ＤＭ 患者１７７例为病例组,对照组为同期在门诊进行健康体检的１７７例非糖尿病 人群。采用以医院为基础的病例对照研究方法,对病例组和对照组进行问卷调查。对研究因素进行单因素 及多因素非条件ｌｏｇｉｓｔｉｃ回归分析。结果　糖尿病家族史（犗犚＝１．９７,９５％犆犐：１．１４～３．４０）; 高血脂 （犗犚＝３．９９,９５％犆犐：１．９６～８．１４）; 心情较差（犗犚＝４．６４,９５％犆犐：１．９３～１１．１８）; 水果摄入量不足 （犗犚＝２．５６,９５％犆犐：１．４４～４．５５）;嗜甜食（犗犚＝１．９４,９５％犆犐：１．０２～３．６９）;睡眠时间不足（犗犚＝ ３．６２,９５％犆犐：１．３３～９．８４）是低龄２型糖尿病发病的危险因素。结论　低龄２型糖尿病是遗传和环境因 素共同作用的结果,应采取综合的防治措施,尤其对高危人群要加强糖尿病的早期筛查工作,控制各种危 险因素。 关键词：糖尿病,２型;低龄;影响因素;病例对照;健康教育;高危人群 中图分类号：Ｒ５８７．１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１９）０３ ０１６９ ０５     

我国吸烟与肺癌关系的Meta-analysis——15个病例对照研究的合并分析

应用Ｍｅｔａ－ａｎａｌｙｓｉｓ方法对国内１５个有关吸烟与肺癌病例对照研究进行了定量综合分析。累积病例为５７０３例，对照为５６６９例。采用Ｐｅｔｏ氏和Ｄｅｒｓｉｍｏｎｉａｎ ａｎｄ Ｎａｎ Ｌａｉｒｄ二氏模型方法处理数据。吸烟因素合并ＯＲ（吸烟与不吸烟对比）在男性为３．０１（２．６３～３．４６），ＰＡＲ为５６．８４％；而在女性合并ＯＲ为２．３２（２．０２～２．６６），ＰＡＲ为３３．１０％、吸烟量、吸     

天津市女性糖尿病危险因素初步研究

对天津市区居民１２１例女性非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病例进行了１：１配对病例对照研究。经条件Ｌｏｇｉｓｔｉｃ回归模型分析，发现与ＮＩＤＤＭ有关的危险因素是：经济收入高（ＯＲ一３．４８，９５％ＣＩ＝２．０２～５．９８）、糖尿病家族史（ＯＲ＝６．３７，９５％ＣＩ＝２．９２～１３．８９）、既往相关病史（ＯＲ＝６．９２，９５％ＣＩ＝３．２５～１４．７３）、绝经年龄晚（ＯＲ＝３，３９，９５％ＣＩ＝２．１５～５．３５）、嗜甜食（ＯＲ＝３．５６，９５％ＣＩ＝２．２９～５．５４）、肥胖（ＯＲ＝１６．３２，９５％ＣＩ＝６．０２～４４．２３）及ＢＭＩ大（ＯＲ＝２．０８，９５％ＣＩ＝１．５２～２．８５）。同时还发现，体育锻炼（ＯＲ＝０．３６，＝３１．４７，Ｐ＜０．０１）和蔬菜、水果等是保护性因素。     

广西吸毒成瘾者丙型肝炎病毒的感染及其分子生物学研究

选择２８３名静脉吸毒者（ＩＶＤＡｓ）和１２１名献血员（ＢＤｓ）进行Ａｎｔｉ－ＨＣＶ、ＨＣＶ血清基因型、ＨＣＶ基因型和ＨＣＶｃＤＮＡ序列的检测。结果表明，ＩＶＤＡｓ和ＢＤｓ的Ａｎｔｉ－ＨＣＶ检出率分别为９１．１７％和０．８３％；ＩＶＤＡｓ的ＨＣＶ血清基因型为１型８１．８５％（２２１／２７０），２型１．４８％（４／２７０），ｌ＋２型０．３７％（１／２７０），不能定为１和／或２型１６．３０％（４４／２７０）；ＨＣＶ基因型为１ａ型：２８．６％（３４／１１９）；ｌｂ型：３８．７％（４６／１１９）；２ａ型１０．９％（１３／ｌ１９）；２ｂ型１４．３％（１７／ｌ１９）；３ａ型２６．９％（３２／１１９）；３ｂ型４０．３％（４８／１１９）；６ａ型８．４％（１０／１１９）；６ｂ型２６．７％（３１／１１９）；其中１４．３％的病例有４～５种不同基因亚型的混合感染现象。     

太原地区戊型肝炎流行特征及其危险因素

为了解本地区戊型肝炎（ＨＥ）流行特征及危险因素，于１９９４年３～１２月对３８５例急性散发性病毒性肝炎进行血清学分型。结果：甲型肝炎１９１例（４９．６１％），乙型肝炎１０４例（２７．０１％），丙型肝炎２０例（５．１９％），ＨＥ３４例（８．８０％），未能分型２２例（５．７２％）。ＨＥ男∶女为６．５∶１，发病平均年龄３８．５岁；临床特点：起病急，病程短，预后好；３例ＨＥ孕妇中，１例发生死胎。将１９９３～１９９４年确诊的７０例ＨＥ病人作病例组，按性别年龄配比选７０例非肝炎病人作对照，进行配比病例对照研究，经单因素和多因素条件ｌｏｇｉｓｔｉｃ回归分析表明：在外用餐史（ＯＲ２．０１，９５％ＣＬ１．２８～３．１５），肝炎接触史（ＯＲ６．０４，９５％ＣＬ１．２４～２９．２９），不洁饮食史（ＯＲ２．１６，９５％ＣＬ２．０５～２．２６），３个因素为本病的主要危险因素。     

饮酒、吸烟与高血压关系的病例对照研究

本调查是在１９９２年底对上海市３个居民点３５岁以上居民高血压普查基础上进行的人群中病例对照配对研究。着重分析饮酒、吸烟及高血压家族史与高血压患病的关系。病例及对照用随机抽样方式分别选自普查得到的高血压人群和正常血压人群。配对条件为性别相同、年龄相近。共调查４９３对病例对照，用配对χ２分析各因素与高血压关系，并用条件Ｌｏｇｉｓｔｉｃ回归分析各因素间的混杂和交互作用。调查结果表明，在上海地区饮酒与高血压病有关，ＯＲ为１．９８（９５％ＣＩ：１．０～３．９）；高血压家族史与高血压病密切相关，在不吸烟者中ＯＲ值高达１８．８（９５％ＣＩ：１０～３５）。研究结果未提示吸烟与高血压有明显关系，ＯＲ值为１．４９（９５％ＣＩ：０．９１～２．４４）。     

茶汤中蛋白钙和非蛋白钙的分析

用三氯乙酸沉淀分离茶汤的蛋白钙（有机钙）和非蛋白钙（游离钙），用原子吸收光谱测定总钙和非蛋白钙含量，用总钙和非蛋白钙差减法计算蛋白钙含量。总钙回收率为９６．６％～９８．８％，非蛋白钙回收率为９８．６％～１０１．２％，批内变异系数为２．３％～２．６％，批间变异系数为４．２％～５．４％。五份乌龙茶茶汤分析结果是总钙含量为３．８１～６．２９ｍｇ／Ｌ，非蛋白钙含量为２．２９～３．６６ｍｇ／Ｌ，蛋白钙含量为１．５２～２．６３ｍｇ／Ｌ，非蛋白钙与蛋白钙比率约为３：２。     

Relationship of epithelial ovarian cancer to other malignancies within families

The relationship of family history of cancer of the breast, colon/rectum, cervix, endometrium, lung, and thyroid to the risk of epithelial ovarian cancer was investigated in a large population-based case-control study. The data consisted of family histories from 493 epithelial ovarian cancer cases and 2,465 controls aged 20-54 years. After controlling for potential confounders, risk for epithelial ovarian cancer was found to be significantly elevated among women reporting breast cancer and colo/rectal cancer in a first-degree relative. Adjusted odds ratios were 1.5 (95% CI = 1.1-2.1) and 1.9 (95% CI = 1.1-3.3), respectively. None of the remaining four types of cancer was found to be statistically associated with the risk of epithelial ovarian cancer. However, when histologic subtypes of epithelial ovarian cancer were considered, a family history of breast cancer was found to be associated with an elevated risk of endometrioid ovarian cancer (odds ratio = 2.3; 95% CI = 1.1-4.7), as was a family history of endometrial cancer (odds ratio = 2.7; 95% CI = 1.0-6.9). The results are considered in the context of other studies of familial patterns of cancer and are compared with published findings concerning the occurrence of multiple primary cancers in the same individual. The findings indicate that further study is warranted regarding possible genetic relationships between epithelial ovarian cancer and cancers arising in other organs.     

甲醛接触工人肿瘤死亡流行病学

采用回顾性队列死亡率研究方法,凡1977年12月31日前在5家脲醛和/或酚醛树脂生产工厂工作满一年以上的工人进入队列,失访率低于5%。观察至1987年12月31日止接触组(1316人男性813人,人年19400)。男性接触组全肿瘤,肺癌、肝癌、胃癌、膀胱癌队列。具统计学意义的超额死亡,男性接触者为全肿瘤,脑瘤、肺癌、胃癌和膀胱癌,女性为全肿瘤,肺癌和肝癌。超额死亡危险随接触工龄延长而增加,三例鼻癌均发生于接触组,工龄在10以上。纠正了吸烟因素后,接触组死亡率高于对照组。     

扬中市上消化道癌地区聚集性研究

目的：探讨恶性肿瘤高发区江苏省扬中市内部是否存在上消化道癌地区聚集性并分析可能的原因，方法：利用扬中市肿瘤发病登记报告系统提供的资料分析各镇胃癌，食管癌，肝癌发病情况，观察地区间差异，并与各镇土壤微量元素硒含量进行相关性分析。结果：Poisson分布配合适度X^2检验；X^2胃癌＝190．4986，X^2食管癌＝103．3659，X^2肝癌＝59．1429，P＜0．001），提示扬中市各镇胃癌，食管癌，肝癌等发病率实际分布与理论分布不一致，其中以三跃镇最高发，三茅镇最低发。胃癌，肝癌发病率与土壤微量元素Se浓度呈负相关，相关系数分别为－0．7312和－0．7091。结论：扬中市上消化道癌分布存在地区聚集性，地质环境的影响可能是其中一个重要因素。     

Formaldehyde and cancer: a critical review

Formaldehyde is a naturally occurring chemical found in every human cell. It has been in widespread use for over a century as a disinfectant and preservative agent, and more recently in a number of industrial products. Animal studies indicate that formaldehyde is a rat carcinogen at high levels (>_ 10 ppm) of exposure. Results for lower levels of exposure show less clear-cut carcinogenic effects, and some species, such as mice and hamsters, appear much less sensitive to any carcinogenic potential of formaldehyde. Epidemiologic studies of the effects of formaldehyde exposure among humans provide inconsistent results. In general, these nonexperimental studies suffer from a number of biases and flaws. The epidemiologic studies fall into three categories: formaldehyde industry workers, case-control studies, and studies of professionals who use formaldehyde. Studies of industry workers with known exposure to formaldehyde report little evidence of an excess cancer risk. Nasopharyngeal cancer, the one cancer considered most strongly linked to formaldehyde among humans, appears after close examination to be likely a result of multiple subgroup analyses and misclassification. The case-control studies usually lack any direct measure of formaldehyde exposure and rely instead on hypothetical exposure based on occupational exposure matrices. Most of these studies, after adjustment for confounding factors, fail to find a significant association with putative formaldehyde exposure. The studies that do report a significant association suffer from methodologic problems limiting their interpretation. The investigations of professionals who use formaldehyde in their work, such as embalmers, pathologists, and anatomists, have the advantage over case-control studies of a much higher likelihood of actual formaldehyde exposure. The findings among these individuals, however, are at odds with those of the other two groups, with excesses of deaths from cancer of the brain and leukemia. The inconsistency between professionals and formaldehyde industry workers in cancer risk patterns suggest that formaldehyde is not the etiologic agent. When the epidemiologic data on formaldehyde and human cancer are examined in light of the widely accepted causal criteria of strength of the association, consistency and specificity of results, dose-response effects, and biologic coherence and plausibility, the studies published so far fail to provide credible causal evidence.     

A mixed methods,community‐based investigation on women's cancer awareness in Haiti

Despite a high number of cases, the awareness of breast and cervical cancer in Haiti and other low and middle‐income countries (LMICs) remains relatively unknown. The objective of the research was to understand perceptions and attitudes towards breast and cervical cancer in Haiti through community‐engaged research. We report Haitians perceptions of breast and cervical cancer symptoms, diagnosis, complications, treatment, community support and access to medical services. Five non‐governmental Haitian organisations performed a large survey across the country of Haiti in 2015. The survey and focus groups addressed demographics, reported knowledge of women's cancer, infrastructural issues and barriers to care, communication and media channels. The mixed quantitative and qualitative surveys with open‐ and closed‐ended questions were administered to 414 participants aged 13–65 (75% of whom were women). A separate, smaller survey on community support and gender‐based violence was conducted in 50 breast cancer patients and survivors as well. The quantitative data indicate low levels of knowledge about cancer across all geographic regions of the country amongst men and women. After coding participants' qualitative responses as “accurate” or “not accurate”, we determined the percentage of accurate responses related to knowledge. Data are reported broken down by geographic region, education, economic status and sex. Approximately one in five respondents reported knowing how a woman contracts breast or cervical cancer. Only 30% reported to know complications of breast cancer and 22% the complications of cervical cancer. When asked if they knew where to get a test for breast cancer, 20% said yes and 33% said they knew where to get a test for cervical cancer. The wealthiest and best educated generally had the most knowledge, but the poorest consistently had the second best. Forty percent of cancer patients reported to be victims of on‐going gender‐based violence. Further investigation should be undertaken examining the role of gender‐based violence and to address the knowledge of the working poor.     

Cancer incidence among laboratory workers in biomedical research and routine laboratories in Israel: Part I-the cohort study

BACKGROUND: Laboratory work is associated with exposure to a mixture of carcinogens. METHODS: The cohort is comprised of 4,300 laboratory workers. Cancer incidence was followed from 1960 to 1997. RESULTS: A total of 230 cases were included in the cohort. The overall cancer standardized incidence ratio (SIR) was 1.04 (0.91-1.18). When a 20-year latency was introduced, SIR was increased significantly: 1.35 (1.13-1.61). Among routine workers and researchers, SIR was elevated significantly for the total population and for women, when a 20-year latency was introduced. SIR was also elevated significantly in research, routine, bacteriology and virology, and isotope laboratories. With respect to specific sites, significantly increased SIR was observed in breast, ovary, and thyroid cancer among women; and prostate cancer, leukemia, and melanoma among men. CONCLUSIONS: We suggest that work in research and biomedical laboratories might involve an increased risk of certain types of cancer. Am. J. Ind. Med. 44:600-610, 2003.     

Cancer incidence among laboratory workers in biomedical research and routine laboratories in Israel: Part II-nested case-control study

BACKGROUND: A case-control study nested within a cohort study of biomedical laboratory workers was conducted to examine whether the excess cancer morbidity that we found can be explained by exposure to a particular group of substances, taking into consideration potential confounders. METHODS: The study population included 163 cases and two matched control groups: laboratory workers (311) and general population (448) workers. RESULTS: Multiple conditional regression analysis showed that working in research laboratories involved an increased risk of cancer generally among women [risk ratio 2.2 (1.2-4.3)], and of breast cancer particularly [risk ratio 2.3 (1.1-4.7). Seventy-six percent (76%) of breast, 87% of thyroid, 60% of ovary and prostate, 94% of melanoma, and 50% of leukemia cases were ever exposed to at least one known human carcinogen. CONCLUSION: Our results exclude the possibility that the excess cancer morbidity was related to personal risk factors but they may be explained by exposure factors. Am. J. Ind. Med. 44:611-626, 2003.