原发性肺腺癌危险因素性别差异分析

为分析不同性别原发性肺腺癌的危险因素，本文对南京市１８０例（男性１００例，女性８０例）原发性肺腺癌进行了配对病例对照研究。条件Ｌｏｇｉｓｔｉｃ多因素模型分析结果表明，烹调油烟污染、慢性支气管炎疾患史、肿瘤家族史等为男女性别肺腺癌发生的共同危险因素。其相对危险度（ＲＲ）对男性分别为２．８４、２．３０、４．８９。对女性分别为３．２０、３．２３、４．２３，另外，男性肺腺癌的发生尚与吸烟有关，ＲＲ为１．０１，女性肺腺癌的发生则与冬季煤炉采暖有关，ＲＲ为２．２９。本文尚分别对各危险因素进行了人群归因危险度的估计。     

病因分值在病例对照研究中的应用──肺癌危险因素的交互效应

对广东省２００例原发性女性肺癌的现患病人作１：１配对病例对照研究，在Ｍａｎｔｅｌ－Ｈａｅｎｓｚｅｌ分层分析和条件ｌｏｇｉｓｔｉｃ回归分析的基础上，探讨女性肺癌危险因素的病因分值以及被动吸烟与其他各种危险因素间的交互效应。多因素条件ｌｏｇｉｓｔｉｃ回归分析结果显示：被动吸烟，厨房通风，喜吃咸食，慢性支气管炎、家庭肿瘤史，肺结核，。服和避孕药是女性肺癌独立的危险因素。     

非吸烟女性肺癌危险因素的多分类logistic模型分析

目的 利用多分类logistic模型分析和评价非吸烟女性不同组织学类型肺癌的危险因素。方法 资料来源于非吸烟女性肺癌病例504例及人群对照601例，拟合多分类logistic回归模型估计各因素的比数比。结果 影响女性腺癌发病的危险因素是厨房小环境污染、经常食用菜油、BMI较低、一级亲属肺癌家族史，而保护因素是活产次数较多和胡罗卜素。女性鳞癌的危险因素则是厨房小环境污染和一级亲属肺癌家族史，保护因素是饮茶。女性其他类型肺癌危险因素主要是油炸烹饪次数较多等，而类型不明肺癌发病的危险因素类似于腺癌。结论 不同组织学类型的非吸烟女性肺癌病因可能存在一定的差异。     

上海市徐汇区女性肺癌病例对照调查

All the 57 female lung cancer patients in Xu-Hui District, Shanghai discovered during 1985 were used as subjects of this study, each was matched with 2 of her near neighbours of same sex and within 5 years of age difference. Smoking, chronic bronchitis, pulmonary tuberculosis and family history of tumour were found to be related with lung cancer in single variable analysis. Upon stratification, smoking and pulmonary tuberculosis were still found related to lung cancer and considered as risk factors with OR and its 95% confidence interval 6.996, 3.23-15.14 and 4.82, 1.37-19.97 respectively. But chronic bronchitis failed to relate with lung cancer and was considered as a confounding factor. Of all the female lung cancer cases only 49.1% and 19.3% were smokers and TB patients respectively, hence smoking and TB could be responsible only for a small portion. In cancer cytology, squamous-cell carcinoma appeared to show association with smoking while adenocarcinoma did not. Among female lung cancer cases the proportion of adenocarcinoma exceeded that of squamous-cell carcinoma, and appeared unrelated with smoking. More family members of the lung cancer cases seem to have had malignant histories, suggesting that a hereditary factor of cancer susceptibility might be involved.     

桐乡市常见恶性肿瘤危险因素分析

目的：了解桐乡市常见恶性肿瘤的危险因素。方法收集桐乡市恶性肿瘤1154例,采用多病例组1∶1匹配的病例对照研究方法,利用多因素非条件Logistic回归模型分析桐乡市常见恶性肿瘤的危险因素。结果精神长期处于压抑状态或者经历精神创伤与肺癌、结直肠癌、肝癌、胃癌和乳腺癌的发病相关（OR＝3.590、3.923、3.896、12.429和11.291）。肺癌、胃癌、结直肠癌和肝癌的共同危险因素有相关疾病史和肿瘤家族史。饮茶和多吃新鲜水果蔬菜是肺癌的保护因素（OR＝0.569和3.161）,而吸烟是肺癌和胃癌的危险因素（OR＝3.826和5.699）。饮酒为结直肠癌和肝癌的危险因素（OR＝3.593和5.316）,而少吃烟熏食品则有利于预防结直肠癌的发生（OR＝0.093）。结论吸烟、饮酒、饮食等生活方式,精神、心理因素、疾病史和肿瘤家族史等为桐乡市常见恶性肿瘤的危险因素。     

肺癌影响因素病例对照研究

目的通过对原发性肺癌相关职业暴露、家族史等危险因素的调查分析,探讨影响原发性肺癌发病的相关因素,为原发性肺癌的预防和控制提供依据。方法采用1∶1配对的病例对照研究,病例选择新入院的经病理诊断确诊为原发性肺癌患者200例;同时在同期住院的非肿瘤、非呼吸道疾病的患者中选择对照200例。调查因素主要包括:一般情况、职业暴露史、疾病史等,所获资料采用SPSS13.0和SAS8.2统计软件进行分析,单因素分析主要根据资料的类型采用χ2检验和单因素条件Logistic回归分析,并采用多因素条件Logistic回归模型进行多因素分析。结果研究结果表明职业有毒有害物质暴露可增加患肺癌的危险性(OR=9.625,95%CI=4.647～19.934),进一步分析发现工作环境中接触石棉、苯、金属粉末和粉尘与肺癌发生具有关联性;胸部放射线检查史、癌症家族史是肺癌发生的危险因素,而感冒次数少是肺癌发生的保护因素;多因素条件logistic回归分析结果显示,工作中接触有毒有害物质、有胸部放射线检查史及肿瘤家族史是肺癌发生的危险因素。结论职业有害因素暴露、肿瘤家族史、胸部放射线检查史是肺癌发生的危险因素。提示对肺癌的预防和控制应采取综合措施。     

Attributable risk for diet,alcohol, and family history in the Melbourne colorectal cancer study

From the data obtained in a large comprehensive population‐based case‐control study of colorectal cancer (The Melbourne Colorectal Cancer Study), attributable risk was calculated for a family history of colorectal cancer in near relatives for diet (when ≥5 of the 11 previously determined dietary risk factors were present) and for beer consumption (for rectal cancer only). The attributable risk was 11% in the presence of a family history of colorectal cancer and 46% in the presence of five or more dietary risk factors. The attributable risk for rectal cancer in the presence of beer consumption was 31% in males and 11% in females. These data are relevant in the consideration of primary prevention of colorectal cancer in Australia, but their general application needs to be approached with caution in view of major differences in the genetic background and the dietary practices in various regions of the world and in view of the uncertainty of what is achievable change, especially for dietary practices.     

胃癌的环境与遗传危险因素及归因危险度分析

目的分析胃癌的环境与遗传危险因素并进行归因危险度评价。方法采用病例对照研究方法．对南京地区121例原发性胃癌病例进行环境危险因素调查，并对相关酶系基因多态性进行分析．综合评价环境危险因素及遗传危险性在胃癌发生中的归因危险度。结果在南京地区人群中，吸烟、食用腌制食品等两种环境危险因素与遗传危险因子细胞色素氧化酶P4502E1(CYP2E1)和N-乙酰化酶(NAT2)的基因型的人群综合归因危险度达69．7％。胃癌的发生主要是环境危险因素与内在遗传持点共同作用的结果。结论对胃癌的干预应同时考虑环境危险因素和遗传危险性，在了解个体遗传易感性的基础上，对其相应的环境危险因素进行干预，以达到Ⅰ级预防的目的。     

胃癌的环境危险因素及其归因危险度分析

目的 分析胃癌的环境危险因素并进行归因危险度评价.方法 采用1:1配对病例对照研究方法,对南京地区121例原发性胃癌病例进行环境危险因素调查,综合评价环境危险因素在胃癌发生中的归因危险度.结果 多因素条件Logistic回归分析显示胃癌的发病与下列4种因素有关:吸烟、食用腌制食品、三餐不定时、消化系统疾病家族史;四因素的调整人群归因危险度ARc%依次为29.9%、24.3%、21.0%、9.46%,综合人群归因危险度sAR为54.7%.结论 在胃癌防治中,可将改变不良饮食习惯、戒除不良嗜好等作为重要的Ⅰ级预防对策.     

Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries in a case-control study based on the INTERHEART study

An international, standardised case-control study was established to assess the importance of risk factors for coronary heart disease worldwide. From 52 countries representing every inhabited continent 15152 cases and 14820 controls were enrolled. The relation of smoking, history of hypertension and/or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins and psychosocial factors to myocardial infarction was reported. Odds ratios and their 99% confidence limits for the association of risk factors to acute myocardial infarction and their population attributable risks were calculated. Smoking (odds ratio 2.87 for current vs never, population attributable risk 35.7% for current and former smoker vs never), raised apolipoprotein B / apolipoprotein A1 ratio (3.25 for top vs lowest quintile, population attributable risk 49.2 for top four quintiles vs lowest quintile), history of hypertension (1.91, 17.9%), diabetes (2.37, 9.9%), abdominal obesity (1.12 for top vs lowest tertile and 1.62 for middle vs lowest tertile, 20.1% for top two tertiles vs lowest tertile), psychosocial factors (2.67, 32.5), daily consumption of fruits and vegetables (0.70, 13.7% for lack of daily consumption), regular alcohol consumption (0.91, 6.7%), and regular physical activity (0.86, 12.2%) were all significantly related to acute myocardial infarction (p < 0.0001 for all risk factors, and p = 0.03 for alcohol). These associations were noted in men and women, old and young and in all regions of the world. Collectively these nine risk factors accounted for 90% of the population attributable risk in men and 94% in women. This finding suggests that approaches to prevention can be based on similar principles worldwide.