我国四个地区肝炎病毒感染与肝癌的病例对照研究

为研究乙型、丙型和庚型肝炎与原发性肝癌的关系，对我国江苏海门、福建同安、广西扶绥和河北石家庄四地，进行了以人群或医院为基础的肝癌病例对照研究。在四个地区病例与对照中，ＨＢｓＡｇ阳性率分别为６６．３％（２３８／３５９）和２３．４％（８４／３５９），其ＯＲ值为６．６０；抗－ＨＣＶ阳性率分别为１７．９％（６１／３４０）和６．５％（２２／３４０），ＯＲ＝３．３１；合并乙丙型肝炎感染其肝癌危险度大大增加（ＯＲ＝１１０．０８）。另对海门病例对照各５０例进行ＨＧＶ－ＲＮＡ检测，阳性率分别为２２％和１０％。结果说明：在我国乙型肝炎感染与肝癌关系更为密切     

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％。     

沈阳市非吸烟女性肺癌危险因素的病例对照研究

于１９９１年４月至１９９４年１２月在沈阳市区内进行了对终身非吸烟女性肺癌危险因素调查的病例对照研究，共选调了新诊断的非吸烟原发性肺癌病例１６６例及相应数量、配比年龄与性别的一般人群为对照，病理组织细胞型以腺癌为主．占６２．２％．其次为小细胞癌．占１７．１％，鳞癌占１４．６％，其他为６．１％，用Ｍｅｎｔａｌ－Ｈａｅｎｓｘｌ法与多因素Ｌｏｇｉｓｔｉｃ回归模型对资料进行分析，其调整ＯＲ与９５％Ｃｌ值：烹饪油烟暴露为４．１１（２．１４～７．８９）．肺部疾病史为２．９８（１．３０～６．４１），亲属患病史为２．９８（１．３０～６．４１），煤烟在单因素分析中对肺癌发生有显著意义．但未进入多因素分析模型。被动吸烟与烧炕史诸因素均未见与肺癌的发生有联系．     

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。     

巢式病例对照研究在通气相关肺炎危险因素调查中的应用

目的研究通气相关肺炎（ＶＡＰ）的致病危险因素。方法采用巢式病例对照研究的方法,对５８例确诊为通气相关肺炎（ＶＡＰ）的病例,按同科室、同性别、年龄相同或相近（±５岁）,入院时间相同或相近（＜１周）,病情相似,１∶１配以５８例对照探讨ＶＡＰ的危险因素。结果对２０多种可能的危险因素进行单因素分析。有１６种呈显著性差异。对这１６种主变量进一步进行多因素条件性Ｌｏｇｉｓｔｉｃ回归分析表明：基础病情重（ＯＲ＝９．４０）、留置胃管（ＯＲ＝８．８６）、患者意识状态差（ＯＲ＝８．３９）、气管切开（或插管）时间长（＞２周）（ＯＲ＝６．８９）、有颅脑外伤（ＯＲ＝６．６０）、频繁更换呼吸机接头插管（ＯＲ＝６．４４）、应激性溃疡预防用药（ＯＲ＝５．５２）、住院时间长（＞１月）（ＯＲ＝４．３１）为ＶＡＰ发生的独立危险因素。结论ＶＡＰ的发生是多因素综合作用的结果,且证明存在胃→咽→下呼吸道的逆行感染途径     

上海市嘉定区肺癌疫情动态及其特点分析

目的掌握上海市郊９０年代肺癌疫情动态。方法分析嘉定区５０万人口,１９８８～１９９８年确诊并随访的１５６５例肺癌临床资料。结果发病率为２９．６／１０万;死亡率为２６．３／１０万,均较前有所上升。发病高峰为６０岁以上老年人,占７３．８％。男女患者之比３．６∶１,女性发病呈增高趋势。地区、职别发病率无明显差异,与同受环境污染、职业致病因子影响有关。９７．２％病例就诊确诊。按ＴＮＭ分期：Ⅰ期１１．３％,Ⅱ期２１．５％,Ⅲａ期３６．４％,Ⅲｂ期２１．９％,Ⅳ期８．９％。手术治疗占１１．４％。１年生存率３１．８％,５年生存率仅３％,与老年患者比例高、病人就诊过晚、延误诊断、晚期病例多等影响治疗有关。结论综合治理环境,对易患人群监测,早发现、早治疗,仍为防治肺癌的当务之急。     

放射工作人员抗EB病毒抗体水平初探

２７８名放射治疗医技师与放射探放人员ＩｇＡ／ＶＣＡ抗体滴度≥１：１０有７４例（占２６．６％），其几何平均滴度为１：１１．８，显著高于本地区一般人群的相应水平。推测职业性长期小剂量电离辐射可能使潜于人体内的ＥＢ病毒受到激活。     

脑出血归因危险度分析

根据脑出血危险因素的病例对照研究资料，初步估计并分析了脑出血的归因危险度和人群归因危险度。结果表明高血压、短暂脑缺血发作（ＴＩＡ）和打鼾的归因危险度分别为９１．４％、９３．８％和５２．７％。以上３种因素的人群归因危险度分别为６８．６％、１８．５％和１９．５％，提示在一般人群中控制高血压、ＴＩＡ和打鼾对预防脑出血具有重要的卫生学意义。     

江西省1995年急性弛缓性麻痹病例实验室监测报告

１９９５年江西省对１５６例急性弛缓性麻痹（ＡＦＰ）病例的粪便标本进行了分离鉴定，分离病毒阳性率为１２．８％，其中非脊灰肠道病毒阳性率为１２．２％，脊灰病毒阳性率为０．６％。通过实验分析证明，病毒分离的阳性率与ＡＦＰ病例粪便标本采集的合格率、及时率、季节变化、年龄分布及细胞的敏感性等因素有关。     

2型糖尿病危险因素的病例对照研究

目的：探讨２型糖尿病危险因素,为制定针对高危人群及全人群的干预措施提供依据。方法：将２００例确诊的２型糖尿病患者作为研究病例,进行１：１配对病例对照研究,通过条件Ｌｏｇｉｓｔｉｃ回归分析筛选主要危险因素。结果：糖尿病家族史（ＯＲ＝８．５６０）、高血压患病史（ＯＲ＝４．８０９）、肥胖（尤其是上身肥胖,即男性ＷＨＲ≥０．９,女性ＷＨＲ≥０．８５）（ＯＲ＝６．７１４１）、高血压、饮食习惯（喜食脂肪）、不常体育锻炼以及精神心理因素（如工作紧张）等是２型糖尿病的主要危险因素。结论：２型糖尿病与遗传因素和环境因素有关,针对高危人群及全人群,采取适度运动、合理膳食、保持良好的精神心理状态,控制体重和血压等综合干预措施是预防２型糖尿病发生的重要手段。     

Alaska Native Cancer epidemiology in the Arctic

Cancer incidence and its possible relation to environmental contaminants, including radiation, continues to be a perceived health threat for the arctic-dwelling Alaska Native (Inupiat Eskimo) people despite the lack of a direct link to high-dose exposure. To better understand this concern, all known malignancies diagnosed in this population (n = 177) in three consecutive eight-year periods (1971–1994) were evaluated.The most recent average incidence rate (age-adjusted to world standard population) of 315 per 100 000 (95% confidence interval, CI = 248–382) represents a 33% surge (albeit non-significant) in Alaska Native cancer incidence over the initial period studied. The male rate 366 (95% CI = 266–466) for the same period exceeds the female rate 258 (95% CI = 169–347) by 42%. Two patterns of cancer incidence are seen at the village level. One, a 24 y upward trend found in the villages of Barrow, Point Hope and Kaktovik (combined rate of increase significant [P = 0.047]) associated with lung cancer; and the other, a stable trend over the past 16 y, associated with colon and rectal cancer. Lung cancer is the predominant cancer by site and is primarily a male disease. The recent male lung cancer incidence rate of 137 (95% CI = 73–201) exceeds the female rate by greater than five times. Total lung cancer cases are primarily confined to four villages where the incidence significantly (P = 0.0043) exceeds the remaining population. The major female cancers are colon/rectal and breast with cancer of the cervix virtually eliminated. Breast cancer is found primarily in two villages where its excess is significant (P = 0.025).Inupiat Eskimo cancer epidemiology is unique, differing from both the Alaska Native and other Circumpolar populations. At present, this uniqueness cannot be explained by an overt environmental contaminant exposure. Although tobacco very likely plays a central role, it by itself cannot fully explain the extremely high male lung cancer rate and why only specific villages are affected. Genetic predisposition and environmental factors may play a synergistic role as cofactors. A cooperative investigative effort with the Inupiat population is indicated and may go a long way in reducing cancer concern in the region.     

Plasma Carotenoids and Retinol and Overall and Breast Cancer Risk: A Nested Case-Control Study

Experimental studies suggest that carotenoids and retinol may play a role in carcinogenesis, but epidemiological evidence is lacking. We investigated the prospective associations between plasma concentrations of major carotenoids and retinol, and overall and breast cancer risk. A nested case-control study included all first incident cancer cases diagnosed in the SU.VI.MAX cohort between 1994 and 2002 (n = 159 cases, 1 matched control/case). Baseline plasma concentrations of carotenoids and retinol were measured by high-performance liquid chromatography. Conditional logistic regression was used to assess odds ratios for an increase of 0.1 μmol/L [odds ratio (OR)] and 95% confidence intervals (CI). Plasma β-carotene (OR = 0.95, 95% CI = 0.90–0.99, P_trend = 0.04) and β-cryptoxanthin concentrations (OR = 0.89, 95% CI = 0.81–0.99, P_trend = 0.03) were inversely associated with overall cancer risk. Plasma β-cryptoxanthin concentration was inversely associated with breast cancer risk (OR = 0.83, 95% CI = 0.71–0.96, P_trend = 0.02). The OR between plasma lycopene concentration and overall cancer risk was 1.07 (0.99–1.15), P_trend = 0.06. This association turned significant (P_trend = 0.01) when excluding cancer cases diagnosed during the first year of follow-up. This prospective study suggests an inverse association between plasma concentrations of β-cryptoxanthin and both overall and breast cancer risk, and an inverse association between β-carotene and overall cancer risk. The direct association between lycopene concentration and cancer risk deserves further investigation.     

Food Groups and Alcoholic Beverages and the Risk of Stomach Cancer: A Case-Control Study in Italy

To investigate the role of a wide range of foods and beverages on the risk of stomach cancer, we analyzed data from a case-control study carried out in Italy between 1997 and 2007 on 230 subjects with incident histologically confirmed stomach cancer (143 men and 87 women, age range 22–80 yr) and 547 controls (286 men and 261 women, age range 22–80 yr) admitted to hospital for acute, non-neoplastic diseases. Odds ratios (OR) of stomach cancer and their corresponding 95% confidence intervals (CI) were estimated using unconditional multiple logistic regression models, adjusted for age, sex, energy intake, and other selected variables. A direct association with stomach cancer risk was observed for cereals (OR = 2.07, 95% CI = 1.01–4.24, for the highest compared to the lowest quintile of intake, P for trend = 0.03), soups (OR = 1.94, 95% CI = 1.10–3.42, P for trend = 0.05), and potatoes (OR = 2.04, 95% CI = 1.05–3.98, P for trend = 0.04). Conversely, inverse trends in risk were observed with vegetables (OR = 0.47, 95% CI = 0.27–0.81, P for trend = 0.01) and fruit intake (OR = 0.53, 95% CI = 0.30–0.93, P for trend = 0.08). The results of this study confirm a protective role of vegetables and fruit against stomach cancer and suggest a detrimental effect of (refined) cereals on this neoplasm.     

Study of lung cancer histologic types, occupation, and smoking in Missouri

A case-control study of lung cancer was conducted to evaluate the relationship between lung cancer histologic types and occupation, adjusted for smoking. A total of 4,431 white male cases and 11,326 cancer controls, diagnosed between 1980 and 1985, were identified through the Missouri Cancer Registry. For all histologic types combined, excess risk was observed among many a priori suspected high-risk occupations. Lung cancer was elevated among men employed as insulators (odds ratio [OR] = 6.0; 95% confidence interval [CI] = 0.7, 137.8), carpenters (OR = 1.3; 95% CI = 1.0, 1.7), painters, plasterers, and wallpaper hangers (OR = 2.0; 95% CI = 1.2,3.3), structural metal workers (OR = 1.9; 95% CI = 0.6,6.0), mechanics and repairers (OR = 1.3; 95% CI = 1.0,1.7), motor vehicle drivers (OR = 1.5; 95% CI = 1.2,1.8), police and firefighters (OR = 1.6; 95% CI = 1.1,2.3), and food service personnel (OR = 1.8; 95% CI = 1.0,3.5). A deficit of lung cancer was observed among farmers (OR = 0.9; 95% CI = 0.7,1.0). Adenocarcinoma of the lung was elevated among carpenters (OR = 1.6; 95% CI = 1.0,2.5) and cabinet and furniture makers (OR = 2.0; 95% CI = 0.4,8.1), which is interesting because of the previous reports of excess adenocarcinoma of the nasal cavity associated with wood dust exposure. Adenocarcinomas were also elevated among plumbers (OR = 2.0; 95% CI = 1.0,3.8) and printers (OR = 1.8; 95% CI = 0.7,4.2). Electricians were at slightly increased risk for adenocarcinoma (OR = 1.5; 95% CI = 0.7,2.8) and "other" or mixed cell types of lung cancer (OR = 1.5; 95% CI = 0.8,2.9) but at decreased risk for small cell (OR = 0.8; 95% CI = 0.3,2.0) and squamous cell (OR = 0.8; 95% CI = 0.4,1.6) tumors. Among welders, adenocarcinoma (OR = 1.7; 95% CI = 0.7,3.8) and squamous cell (OR = 1.7; 95% CI = 0.9,3.3) cancers were elevated, but small cell and "other" lung cancers were not. Despite the limitations of the Cancer Registry data, some interesting associations were observed that merit further study, particularly the association between lung adenocarcinoma and occupational exposure to wood and wood dust.     

Fish Consumption and Lung Cancer Risk: Systematic Review and Meta-Analysis

There is evidence pointing to a possible role of diet on cancer etiology. Prior studies evaluating the relationship between fish consumption and lung cancer risk reported inconclusive results. The aim of this study was to achieve a comprehensive assessment of the relationship between fish consumption and lung cancer risk through systematic review and meta-analysis. Case control and cohort studies up to September 1, 2012 about fish consumption and lung cancer risk were confirmed by an online search. Separate relative risk (RR) or odds ratio (OR) estimates with 95% confidence interval (CI) of the relationship between lung cancer risk and fish consumption level from the included articles were combined by Stata11.0 software. Publication bias was evaluated by Egger's linear regression test and funnel plot. Twenty articles (17 case-control and 3 cohort studies) comprising 8799 cases of lung cancer and 17,072 noncases were included in the final analysis. The pooled results from all studies indicated that high fish consumption was significantly associated with a decreased risk of lung cancer (pooled RR: 0.79; 95% CI: 0.69–0.92). There was heterogeneity among the studies (I² = 73%, P < 0.05). Pooled RR in case control and cohort studies were 0.76 (95% CI: 0.63–0.91) and 0.95 (95% CI: 0.73–1.24), respectively. Omission of any single study had little effect on the combined risk estimates. This article had no publication bias. This study identifies a significant association between fish consumption and lung cancer, confirming a protective role of fish in lung cancer. More well-designed prospective studies are required to further verify the effect of fish consumption on lung cancer.     

谷胱甘肽硫转移酶Mul—1（GSTM1）基因多态性与肺癌易感性关系的研究

目的　探讨中国汉族广东人群中谷胱甘肽硫转移酶 Mul- 1(GSTM1)基因缺失及吸烟与肺癌易感性的关系。　方法　采用病例 -对照研究方法 ,应用 PCR技术检测 91例肺癌患者、138例对照的 GSTM1基因多态性。　结果　GSTM1基因缺失在肺癌组和对照组中的频率分别为 6 1.5 %和 5 2 .9% ,OR=1.38(0 .80～ 2 .38)差异无统计学意义 (P>0 .0 5 ) ,与吸烟联合分析时发现 GSTM1基因缺失的 OR值为 3.0 7,比单纯吸烟对肺癌的 OR值 (1.87)大 (P<0 .0 1)。　结论　 GSTM1基因缺失与吸烟可能协同增加患肺癌的危险性     

Meat Consumption and Risk of Lung Cancer Among Never-Smoking Women

The relationship between diet and lung cancer, apart from the protective effect of fruit and vegetables, is poorly understood. Reports on the role of dietary components such as meat are inconsistent, and few studies include sufficient numbers of nonsmokers. We examined the relationship between meat consumption and never-smoking lung cancer in a hospital-based case–control study of Singapore Chinese women, a population with low smoking prevalence. Three hundred and ninety-nine cases and 815 controls were recruited, of whom 258 cases and 712 controls were never smokers. A standardized questionnaire (which included a food frequency questionnaire module) was administered by trained interviewers. Among these never smokers, fruit and vegetable intake were inversely associated with lung cancer risk. Seventy-two percent of meat consumed was white meat (chicken or fish). Meat consumption overall was inversely associated with lung cancer [adjusted odds ratio (OR), 0.88, 0.59 for second, third tertiles, P _trend = .012]. An inverse relationship between fish consumption and lung cancer (adjusted OR, 0.81, 0.47 for 2nd, 3rd tertiles, P _trend < .001) was observed. No association was seen between consumption of processed meats and lung cancer, nor between dietary heterocyclic amines and lung cancer. Our data suggest that fish consumption may be protective against lung cancer in never smokers.     

Dietary Intake of Soy Protein and Tofu in Association With Breast Cancer Risk Based on a Case-Control Study

Soy food and its constituents may protect against breast cancer, but the association between soy intake and decreased breast cancer risk is inconsistent. We evaluated the relationship between breast cancer risk and the dietary intake of soy protein as measured by total soy food and tofu intake. Histologically confirmed cases ( n = 362) were matched to controls by age (within 2 yr) and menopausal status. High soy protein intake was associated with reduced breast cancer risk in analyses adjusted for potential confounders including dietary factors among premenopausal women (odds ratio [OR] = 0.39 in the highest quintile, 95% confidence interval [CI] = 0.22–0.93, P for trend = 0.03) and postmenopausal women (OR = 0.22, 95% CI = 0.06–0.88, P for trend = 0.16). We also found an inverse association between total tofu intake and breast cancer risk among premenopausal women (for total tofu intake, OR = 0.23 in the highest quintile, 95% CI = 0.11–0.48, P for trend < 0.01; for at least 1 serving of tofu as the main ingredient per day, OR = 0.26, 95% CI = 0.13–0.55, P for trend < 0.01). We concluded that increased regular soy food intake at a level equivalent to traditional Korean consumption levels may be associated with a reduced risk of breast cancer, and this effect is more pronounced in premenopausal women.     

Public awareness of colorectal cancer and screening in a Spanish population

Objectives

To investigate screening intentions and previous uptake of colorectal cancer (CRC) screening tests in a general population in Spain; and to determine knowledge about CRC, risk perceptions, major barriers to screening and perceived benefits of screening.

Study design

Cross-sectional study.

Methods

Six hundred consecutive Spanish individuals over 50 years of age completed a questionnaire to determine their screening intentions, previous CRC diagnostic procedures, and knowledge about screening procedures, risk factors for CRC, 5-year prognosis, warning signs and symptoms, incidence, age-related risk and perceived barriers to screening.

Results

Although 78.8% of subjects reported that they were willing to participate in CRC screening, only 12% had ever undergone a screening test, and none with screening intention. Awareness of a breast cancer screening test [odds ratio (OR) 1.67, 95% confidence interval (CI) 1.04–2.70; P = 0.035], visiting a general practitioner in the preceding year (OR 3.08, 95% CI 1.86–5.08; P < 0.0001), awareness of risk factors (OR 2.32, 95% CI 1.49–3.61; P < 0.001), awareness of CRC signs or symptoms (OR 1.65, 95% CI 1.03–2.64; P = 0.04) and belief in the efficacy of CRC screening (OR 8.85, 95% CI 1.53–51.3; P = 0.01) were independent predictors for intention to participate in CRC screening. The most common reasons given for refusing screening were ‘CRC tests might be dangerous’ (28.2%), ‘CRC tests might be painful’ (17.9%) and ‘feeling healthy’ (16.2%).

Conclusion

Although reported willingness to undergo CRC screening was high, CRC knowledge and actual uptake of CRC screening were low. An educational intervention to reduce barriers and increase awareness could improve uptake of CRC screening.     

Prevalence of and Factors Associated with Sarcopenia in Korean Cancer Survivors: Based on Data Obtained by the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2011

Using a representative dataset from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011, we analyzed anthropometric and dual-energy X-ray absorptiometry (DXA)-determined body composition findings for 493 cancer survivors (mean age a61.1 ± 12.6 years; 35.7% male). A much higher proportion of men (30.1%) than women (0.6%) met the criteria of sarcopenia. Subjects with a history of lung cancer, genitourinary cancer, or gastric cancer were prone to develop sarcopenia (31.6%, 26.3%, and 21.4%, respectively). Furthermore, sarcopenia was more prevalent among elderly (≥65 years; P < 0.001), those with a lower BMI level (<23 kg/m²; P < 0.001), heavy drinker (P = 0.012), or smoker (P < 0.001), and those with inadequate intakes of protein (P = 0.017) and vitamin A (P = 0.024). Multivariable logistic analyses revealed sarcopenia was significantly associated with male gender (odds ratio [OR], 68.14; 95% CI, 15.52–299.13), a BMI of <23 kg/m² (OR 35.93, 95% CI, 8.24–156.67), and inadequate protein intake (OR 3.07, 95% CI, 1.30–7.22); these factors are significant predictors of sarcopenia in Korean cancer survivors.