肺癌危险因素的Meta分析

目的探讨人群肺癌发生的危险因素,为制定肺癌的预防控制措施提供科学依据。方法计算机检索MEDLINE、CNKI和CBM,并辅以手工检索、文献追溯等方法,收集国内外1997年1月～2007年1月公开发表的关于人群肺癌发病危险因素的研究文献,采用RevMan4.2软件进行Meta分析。结果共纳入40篇文献,累计病例16559例,对照25119例。各因素合并比值比（OR）分别为：吸烟（5.75）、女性被动吸烟（来源于丈夫）（1.32）、女性被动吸烟（来源于同事）（1.21）、慢支炎（1.68）、肺气肿（2.70）、肺结核（1.58）、肿瘤家族史（1.24）、肺癌家族史（1.59）。吸烟、女性被动吸烟（来源于丈夫）、女性被动吸烟（来源于同事）、慢支炎、肺气肿、肺结核、肿瘤家族史、肺癌家族史和石棉暴露对肺癌的人群归因危险度百分比分别为69.16%、14.52%、5.87%、7.45%、10.18%、1.91%、8.92%、5.33%和7.37%。结论目前影响人群肺癌发生的危险因素为吸烟、女性被动吸烟（来源于丈夫）、女性被动吸烟（来源于同事）、慢支炎、肺气肿、肺结核、肿瘤家族史和肺癌家族史等。人群归因危险度百分比的计算表明,吸烟最高,其次是女性被动吸烟（来源于丈夫）,再次是肺气肿和肿瘤家族史等,提示环境因素和遗传因素在人群肺癌发病中均具有重要作用。

Risk Factors on Lung Cancer: A Meta-Analysis

Objective To study the risk factors of lung cancer and provide scientific evidence for preventing and managing such disease.Methods The database of MEDLINE,CNKI,and CBM were searched and literature domestically and internationally from January 1997 to January 2007 was collected.The RevMan 4.2 software was used for meta-analysis.Results A total of 40 studies involving 16 559 cases and 25 119 controls were included.The pooled OR values and population attributable risk percentage（PARP） for smoking,female passive smoking from husband,female passive smoking from colleague,chronic bronchitis,emphysema,pulmonary tuberculosis,family history of cancer,and family history of lung cancer were 5.75（69.16%）,1.32（14.52%）,1.21（5.87%）,1.68（7.45%）,2.70（10.18%）,1.58（1.91%）,1.24（8.92%）,and 1.59（5.33%）,respectively.Conclusion Risk factors related to the incidence of lung cancer are smoking,female passive smoking from husband and colleague,chronic bronchitis,emphysema,pulmonary tuberculosis,family history of cancer,family history of lung cancer and so on.Besides,the results of PARP indicate that smoking is the most important factor,followed by female passive smoking from husband,emphysema,family history of cancer sequentially,which suggest that environmental and genetic factors play important roles in the development of lung cancer.