青石棉污染区恶性胸膜间皮瘤发病危险因素的调查

目的　探讨间皮瘤发病的影响因素 ,以期为间皮瘤的预防及进一步研究发病机制提供流行病学依据。方法　采用 1∶1配比的病例 -对照设计调查了 2 3例间皮瘤病例和对照 ,比较两组间的石棉接触情况、生活方式及一级亲属恶性肿瘤发病情况。结果　病例组平均年龄 5 7.96岁 ,间皮瘤平均潜伏期为 5 2年 ,与对照组相比 ,其石棉接触年龄、接触时间以及吸烟、饮酒习惯的差异均无显著性 (P >0 .0 5 ) ;病例组平均累积石棉纤维接触剂量为 37.2× 10 5f,明显高于对照组 (32 .3× 10 5f) ,差异有显著性 (P =0 .0 0 5 ) ,且随剂量的增高 ,OR值有升高趋势。病例组一级亲属患恶性肿瘤的比例(2 6 .1%)高于对照组 (4 .4%) ,差异有显著性 (P <0 .0 5 ) ,OR =7.75 (95 %CI:0 .85～ 71.43)。结论　石棉接触与间皮瘤发病间可能存在剂量 -效应关系 ;癌家族史可能是间皮瘤的一个危险因素 ,或者在相同的石棉接触水平下可增加个体对间皮瘤的易感性。

Risk factors for malignant pleural pleural mesothelioma in crocidolite contaminated area

OBJECTIVE: To explore the risk factors for mesothelioma so as to provide epidemiological evidences for prevention of this disease and for further study of its pathogenesis. METHODS: A 1:1 paired case-control study was carried out in which asbestos exposure, life style and histories of cancer in first-degree relatives of 23 patients who had mesothelioma were compared with those of controls. RESULTS: The mean age of patients was 57.96 years with a latency period of 52 years. There were no significant differences in mean exposure age, mean exposure periods, and smoking, drinking habits between patients and controls. The mean cumulative exposure of patients was 37.2 x 10(5) f, which was significantly higher than that of controls (32.3 x 10(5) f, P = 0.005). The odds ratio increased with the cumulative exposure. The percentage of cancer in first-degree relative of patients (26.1%) was significantly higher than that of controls [(4.4%, P < 0.05), OR = 7.75 (95% CI: 0.85-71.43)]. CONCLUSION: There may be a dose-response relationship between mesothelioma and asbestos exposure. A family history of cancer may be a risk factor for mesothelioma, or may indicate an increased susceptibility to mesothelioma under the same level of asbestos exposure.