阳江天然放射性高本底和对照地区居民鼻咽癌死亡病例对照研究

目的 探讨阳江高本底辐射调查地区居民鼻咽癌的相关危险因素,为正确评价高本底辐射致癌危险提供基础。方法 选择固定队列中1987～1995年间鼻咽癌死亡病例作为研究对象,随机选择对照,1∶2配对。研究的因素包括职业、文化程度、居住史与生活环境等一般社会经济状况,农药使用,吸烟、饮酒、饮食、医用X射线照射和鼻咽癌家族史等。资料收集采用面访方式。资料采用条件Logistic回归分析,计算比数比(OR)及相应的95%置信区间和P值。结果 有效访问了102例病例和202例对照。单因素Logistic回归分析发现,经常摄入咸鱼、咸菜、豆豉和腊肉,慢性鼻炎史,家族鼻咽癌史等因素与鼻咽癌有显着性关联；多因素Logistic回归分析的结果显示,经常摄入咸鱼,慢性鼻炎史和家族鼻咽癌史是鼻咽癌独立的危险因素；在控制某些因素后,引入高本底辐射,吃咸鱼和豆豉,吸烟和饮酒等因素进行多因素Logistic回归分析,结果显示吃咸鱼为鼻咽癌发病唯一危险因素(OR=2.8,95%CI:1.52～5.18);吸烟(OR=1.2,95%CI:0.65～2.22)、饮酒(OR=0.83,95%CI:0.38～1.78)和高本底辐射(OR=0.86,95%CI:0.44～1.68)与鼻咽癌的发病无明显关联。结论 经常吃咸鱼是鼻咽癌发病的重要危险因素；高本底地区居民的鼻咽癌发病与本底辐射关明异关系。

A case control study of nasopharyngeal carcinoma among inhabitants in high background radiation areas of Yangjiang, China

Objective The purpose of the study was to confirm and explore main risk factors of nasopharyngeal carcinaoma (NPC) in cohort members of the investigated areas,and evaluate effects of confounding factors on cancer risk associated with exposure to high background radiation. Methods The deceased cases of NPC during the period of 1987-1995 were selected as study subjects for each of whom two controls were randomly selected from potential control subjects who died from causes other than malignant tumors and external causes,and matched for sex and years of birth and death (within 5 years).Using structure questionnaire,the relevant information including socioeconomic status,dietary habits,smoking and alcohol consumption,history of illness,agricultural use of pesticide,medical X-ray exposure and familial history of NPC were collected.The odds ratio (OR) was used as a measure of association between NPC and the risk factors. Results 102 cases and 202 controls were successfully investigated.Single factor conditional logistic regression analysis showed that the occurrence of NPC was closely positively associated with intake of salted fish,pickles,fermented soybeans,cured meats,history of chronic rhinits and familial history of NPC.Further multiple conditional logistic regression analysis turned out that intake of salted fish,history of chronic rhinits and familial history of NPC were the the independent risk factors of NPC.After controlling for history of chronic rhinits and familial history of NPC,the results based on multiple conditional logistic regression analysis from high background radiation,intake of salted fish and fermented soybeans,tobacco smoking and alcohol consumption showed that only intake of salted fish was a significant risk factor (OR=2.8,95%CI 1.52-5.18),tobacco smoking (OR=1.2,95%CI 0.65-2.22),alcohol consumption (OR=0 83,95%CI 0.38-1.78) and exposure to high background radiation (OR=0.86,95%CI 0.44-1.68) did not increase risk of NPC. Conclusiones alted fish consumption was closely associated with an increased risk of NPC,and exposure to high background radiation in the HBRA was not a significant risk factor of NPC.