粤桂沿海地区居民食管癌发病影响因素的病例对照研究分析

目的：分析粤桂沿海地区居民食管癌发病影响因素，为有效防治食管癌提供科学依据。方法：采用病例对照研究方法对2011年9月至2013年3月在广东湛江中国人民解放军第422医院及广西医科大学第一附属医院的196例沿海地区食管癌患者及其同期住院的201例非食管癌患者进行食管癌影响因素及C型行为特征问卷调查。结果：与对照组比较，病例组在食用烫食、食用硬食、饮食时间、饮食速度，食用咸鱼、食用水果、蔬菜，吸烟、饮酒及饮茶等生活习惯上差异均有统计学意义（P〈0．05）；且在焦虑、抑郁、愤怒、愤怒向内、理智、控制得分上均高于对照组，而愤怒向外、乐观及社会支持得分低于对照组，且两组差异有统计学意义（P〈0．01）；多因素Logistic回归分析显示居住在农村、经常饮酒、饮食速度快、食用咸鱼以及焦虑、抑郁、愤怒、愤怒向内、理智、情绪控制等得分高是粤桂沿海地区居民食管癌发病的危险因素，而经常食用水果、蔬菜是其保护因素。结论：粤桂沿海地区居民食管癌的发生与环境、饮食及C型行为等因素有关，在其预防措施上应根据具体情况采取有针对性的措施。

CASE-CONTROL STUDY AND INFLUENTIAL FACTOR ANALYSIS OF ESOPHAGEAL CANCER IN THE GUANGDONG AND GUANGXI COASTAL AREAS

Objective：To analyze the influential factors of esophageal cancer among residents in the Guang- dong and Guangxi coastal areas, and to provide scientific evidences for prevention of esophageal cancer ef- fectively. Methods： A case-control study was conducted among 196 esophageal cancer patients and 201 non- digestive tract disease patients. The subjects were recruited from the No. 422 Hospital of the People＇s Lib- eration Army and the First Hospital of Guangxi Medical University between September 2011 and March 2013. The influential factors and type-C behavior were investigated among them. Results： There was sig- nificant difference in eating hot and hard food, eating time and speed, eating salted fish, taking fruit and vegetables, smoking, alcohol consumption and driving tea （ P〈0.05）. The scores of anxiety, depression, anger, intrinsic anger, reason and control in the case were higher than those in the emotional controls, but the extrinsic anger, optimist and social support in the case were lower than those in the emotional controls （ P〈0.01）. Multinomial logistic regression analyses showed that living in rural area, alcohol consumption usually, eating fast, eating salted fish and with higher scores of anxiety, depression, anger, intrinsic an- ger, reason and emotional controls were risk factors for esophageal cancer. Eating fruit and vegetable usu- ally were protective factors for esophageal cancer. Conclusion： The incidence of esophageal cancer is strong- ly associated with environment, diet and type-C behavior among the resident in the coastal areas of Guang- dong and Guangxi, and specific preventive measures should be taken in different populations.