心理因素及胃慢性疾病与胃癌关系的病例对照研究

目的研究心理因素及胃慢性疾病对胃癌发生的影响.方法采用1:3配对病例对照研究方法,对201对胃癌病例和对照进行问卷调查.应用条件Logistic回归模型进行单因素分析和多因素分析,计算比值比及其95%可信区间.结果经多因素分析有意义的因素为情绪调节差(OR=5.17,95%CI:2.81～9.51)、精神压抑(OR=10.55,95%CI:5.43～20.51)、胃溃疡(OR=10.26,95%CI:4.36～24.15)、胃炎(OR=8.52,95%CI:3.55～20.45),此外,它们具有显著的交互作用(β=4.69).结论心理因素及胃慢性疾病史是胃癌的主要危险因素,保持良好的心态,早期、彻底根治胃慢性疾病是降低胃癌发生的重要措施之一.     

福建省贲门癌发病因素的病例对照研究

 目的　探讨贲门癌发生的危险因素。方法采用病例对照研究方法 ,研究对象 5 82例 ,其中贲门癌新病例 2 91例 ,对照 2 91例。应用统一制订的调查表进行流行病学调查。对资料进行单因素和多因素Logistic回归分析。 结果　贲门癌的危险因素有 :三餐不按时 (OR =1.4 4,95 %CI :1.15 1.81)、进食快 (OR=1.4 0 ,95 %CI :1.0 9 1.80 )、食用猪油 (OR =1.6 7,95 %CI :1.19 2 .35 )、饮用井水 (OR =1.90 ,95 %CI :1.2 7 2 .84 )、吸烟 (OR =1.2 8,95 %CI :1.0 5 1.5 8)和家庭肿瘤史 (OR =3.15 ,95 %CI :1.97 5 .0 4 )。常吃新鲜蔬菜(OR =0 .5 3,95 %CI :0 .2 8 0 .99)、水果 (OR =0 .75 ,95 %CI :0 .5 6 1.0 0 )、牛奶 (OR =0 .5 2 ,95 %CI :0 .2 9 0 .93)及文化程度高者 ,其胃癌发生风险低。结论　本研究首次发现不良的饮食方式是贲门癌的危险因素 ,对...     

江苏省恶性肿瘤低发区食管癌危险因素研究

[目的]探讨江苏省恶性肿瘤低发地区食管癌发病的有关危险因素及保护因素.[方法]在江苏省恶性肿瘤低发的赣榆地区进行了食管癌1:1配对病例对照研究,共调查病例与对照各95例,应用条件Logistic回归对相关因素进行单因素和多因素分析.[结果]热烫饮食(OR=2.066,95%CI=1.116～3.828)、饮酒(OR=3.206,95%CI=1.866～5.509)为该地区食管癌发病的主要危险因素,而生吃大蒜(OR=0.423,95%CI=0.209～0.856)、喜食蔬菜(OR=0.485,95%CI=0.267～0.881)、喜食干果(OR=0.333,95%CI=0..168～0.660)和性格开朗(OR=0.469,95%CI=0.254～0.866)则为该地区食管癌的主要保护因素.[结论]在江苏肿瘤低发区热烫饮食、饮酒仍是食管癌的危险因素,而生吃大蒜、蔬菜、干果和性格开朗是保护因素.     

饮绿茶对胃癌、慢性胃炎发病影响的流行病学调查

目的尽管我国胃癌死亡率有下降趋势,但仍旧是第二位恶性肿瘤,扬中是我国胃癌高发区之一.我们在扬中进行胃癌和慢性胃炎与饮绿茶的调查,以研究饮绿茶与它们发病的关系.以及他们之间的交互作用.方法在扬中开展以人群基础的病例对照调查其中有病理学证明的胃癌143例,慢性胃炎166例和对照433例.用统一的流行病学调查表,同时采血作幽门螺杆菌感染测定.分析用logistic回归计算比数比(OR)和95%可信限(CI).分析时用各种混杂因素进行调整.结果饮绿茶可降低胃癌和慢性胃炎危险度各54%,其比数比分别为0.46(95%CI0.22-0.96)和0.46(95%CI0.27-0.77).每周饮绿茶杯数愈多,胃癌和慢性胃炎OR下降愈低(趋势检验P＜0.05).饮绿茶与胃癌家族史,幽门螺杆菌感染和饮酒可能有相乘交互作用.结论饮绿茶可降低胃癌和慢性胃炎危险度各54%.     

幽门螺杆菌与其它危险因素交互作用致胃癌关系的研究

[目的]探索泰兴市幽门螺杆菌(Hp)与其它危险因素致胃癌的交互作用。[方法]选择92例胃癌新发病例按性别、年龄(±2岁)和居住地进行1∶1配对的病例对照研究 ,对全部研究对象检测了Hp抗体。[结果]病例组Hp阳性率(54.35%)显著高于对照(33.70%),Hp阳性患胃癌的OR值为2.34(95%CI1.23～4.48) ,Hp阳性同时又暴露于长期吃新鲜蔬菜少、长期吃新鲜水果少、不吃香菇和慢性胃炎因素致胃癌发生的OR值分别为5.34～5.39,4.11～6.72,4.72和6.50,其两因素交互作用指数分别为0.34～0.42,0.24～0.67,0.44和0.01,Hp阳性合并上述危险因素可能存在相加的交互作用方式 ,在控制了彼此的混杂作用后 ,下列因素致胃癌的作用大小依次为 :胃溃疡(OR=18.0)>Hp阳性合并胃炎(OR=9.00)>慢性胃炎(OR=6.38)>Hp阳性(OR=3.43)。[结论]Hp感染是泰兴市胃癌高发的重要危险因素之一 ,其与上述危险因素在致胃癌的关系中存在着显著的协同作用。     

既往疾病史和胆道癌关系的全人群病例对照研究

目的　研究分析既往疾病史和胆道癌 (包括胆囊癌、肝外胆管癌和壶腹部癌 )的关系。方法　自 1997年 6月～ 2 0 0 1年 5月 ,在上海市区开展了一项大规模的基于全人群的胆道癌的病例对照研究 ,共收集、调查了 6 6 4例胆道癌新病例和 894例人群对照。结果　研究发现既往有胆囊炎疾病史者患胆囊癌、肝外胆管癌的危险性升高 ,调整的比数比分别为 2 .2 (95 %CI =1.3～ 3.6 )和 1.9(95 %CI=1.0～ 3.3)。糖尿病患者患胆囊癌的危险性增加 ,调整的比数比为 1.5 (95 %CI=0 .9～ 2 .5 ) ,在非胆结石者中调整的比数比为 2 .0 (95 %CI=0 .9～ 4 .5 ) ;此外 ,研究还发现肝硬化者患肝外胆管癌的危险性明显增加 ,调整的比数比为 3.0 (95 %CI=1.0～ 9.1) ,在非胆结石者中调整的比数比为 4 .9(95 %CI=1.2～ 19.8)。结论　该项研究为论证胆囊炎症增加患胆道癌的危险性提供了依据 ,研究还提示糖尿病和肝硬化分别提高患胆囊癌和肝外胆管癌的危险性。     

广东地区前列腺癌发病与家族史和婚育史关系的病例对照研究

背景与目的:前列腺癌(prostate cancer)是欧美发达国家老年男性的常见恶性肿瘤之一,中国前列腺癌的发病率较低,但逐年上升.国内前列腺癌的病因学研究主要集中于上海、武汉和北京等地区,而来自广东地区的报道较少.本研究旨在探讨广东地区前列腺癌与家族史和婚育史的病因学关联.方法:在中山大学4所附属医院开展一项病例对照研究(1:2配对),匹配条件为年龄组(±5岁)、性别、民族和居住地类型相同.调查以面谈为主,辅以调查病历记录,采用条件Logistic回归法分析数据.结果:本次调查共获得有效资料186份,其中前列腺癌患者62例,良性前列腺增生的患者62例和其他疾病对照62例.以前列腺增生为对照,遗精年龄小于15岁者患前列腺癌的危险是18岁以上者的6.37倍(95%CI=0.63～63.95);与30岁以上首次进行性生活者相比,首次性生活年龄小者患前列腺癌的危险增高,20～24岁组OR=2.25(95%CI=0.75～6.71),25～29岁组OR=2.34(95%CI=0.89～6.13);60岁以后失去性生活者是前列腺癌的保护因素,60～69岁OR=0.51(95%CI=0.20～1.27),70岁及以上组OR=0.31(95%CI=0.08～1.24).以其它疾病为对照,有一个一级亲属患恶性肿瘤者患前列腺癌的危险是无恶性肿瘤家族史的2.25倍(95%CI=0.69～7.31);首次性生活年龄小于20岁者患前列腺癌的危险是30岁及以上者的5.07倍(95%CI=0.50～51.46);而60岁以后失去性生活者是前列腺癌发生的保护因素,60～69岁组OR=0.55(95%CI=0.24～1.26),70岁及以上组OR=0.41(0.11～1.47).结论:首次遗精年龄和首次性生活年龄较早均为前列腺癌的危险因素,有恶性肿瘤家族史者患前列腺癌的危险增加.     

江苏省大丰市胃癌危险因素病例对照研究

[目的]探讨大丰市与胃癌发病有关的危险因素。[方法]选择大丰市进行以人群为基础的胃癌1∶1配对病例对照研究，共调查胃癌病例和对照各649例，配成对数649对。结果采用单因素及多因素条件Logistic回归方法进行分析。[结果]A型血（OR=3.127，95%CI：1.488～6.571），进食速度快（OR=3.587，95%CI：2.570～5.006），喜食咸（OR=2.703，95%CI：1.261～5.794）或烫（OR=3.445，95%CI：2.526～4.697）食品，性格忧郁（OR=2.512，95%CI：1.333～6.819）等为大丰市胃癌发病的主要危险因素，而粮食储具常清洗翻晒（OR=0.054，95%CI：0.004～0.815），喜食大蒜（OR=0.337，95%CI：0.048～0.651），常食用新鲜蔬菜（OR=0.488，95%CI：0.274～0.869）等则为其保护因素。[结论]应当通过教育居民改变不良的生活饮食习惯、注意心理精神卫生以降低胃癌发病危险性。     

中国人群IL-1基因多态性与胃癌发生易感性Meta分析

目的:探讨中国人群IL-1基因多态性与胃癌发生的相关性.方法:通过检索MEDLINE、Embase、Cancerlit、AACR(American association for cancer re-search)、中国生物医学文献数据库(CBM-disc)、中国知网、万方数据库等数据库,纳入16个关于IL-1-31,IL-1B-511,和IL-1RN基因多态性和胃癌相关性的病例对照研究.采用RevMan 4.2.2统计软件进行文献的异质性检验并计算合并效应优势比(OR)和95%可信区间(CI).结果:经筛选纳入16个病例一对照研究,其中包舍2 099例胃癌病例和2 371个正常对照,IL-1B-31C,IL-1B-511T和IL-1 RN 3个位点的OR和C1分剐是[0R=0.98,95%CI(0.72～1.34);P=0.89]、[0R=1.45,95%CI(1.00～2.09);P=0.05]、[0R=1.61,95%CI(0.97～2.67);P=0.07].结论:在中国人群中,IL-1B-31和IL-1RN两位点基因多态性与胃癌发生不存在关联性,IL-1B-511位点基因多态性与胃癌发生易感性相关联.     

细胞色素P450 2E1(CYP2E1)基因多态性与胃癌易感性的Meta分析

[目的]探讨细胞色素P4502E1(CYP2E1)基因多态性与胃癌易感性的关系。[方法]检索PubMed和CNKI数据库中有关CYP2E1基因多态性与胃癌易感性关联研究的文献,对入选文献以OR为效应指标,应用RevMan4.28软件包进行Meta分析。[结果]纳入11篇文献,共1352例胃癌病例和1866例对照;Meta分析结果显示,合并OR值为0.73(95%CI=0.60￣0.91),按人群分层后,中国人群合并OR值为0.54(95%CI=0.31￣0.94),其他人群合并OR值为0.83(95%CI=0.69￣1.01)。[结论]CYP2E1突变基因型(c1c2或c2c2)是胃癌的保护因素,但这一结果有待进一步严格设计的大样本病例对照或前瞻性研究予以验证。     

Salt and gastric adenocarcinoma: a population-based cohort study in Norway.

BACKGROUND: Gastric adenocarcinoma is the second leading cause of cancer death worldwide. It has been suggested that consumption of salted foods is associated with increased risk of this cancer, but the results of the few available prospective studies are contradictory. METHODS: A population-based, prospective cohort study in Nord-Trondelag County in Norway during 1984 to 2002 addressed dietary salt intake in relation to risk of gastric adenocarcinoma. In 1984 to 1986, all adult county residents were invited to a health survey in which participants answered questionnaires concerning dietary salt intake and other factors. Gastric adenocarcinomas were identified in the Norwegian Cancer Registry. Relative risks were calculated using Cox proportional hazards regression models, adjusted for potentially confounding factors. RESULTS: Follow-up of 1,122,765 person-years at risk among 73,133 cohort members disclosed 313 incident cases of gastric adenocarcinomas occurring at least 3 years after inclusion into the cohort. There were no statistically significant associations between different levels of salt intake and risk of gastric adenocarcinoma. High consumers of dietary salt were not at increased risk of developing gastric adenocarcinoma compared with low consumers (hazard ratio, 1.0; 95% confidence interval, 0.7-1.4), and no dose-response effect was observed (P(trend) = 0.55). CONCLUSION: High intake of dietary salt does not appear to increase the risk of gastric adenocarcinoma in this low-incidence western population.     

辽宁省胃癌高低发地区胃癌影响因素分析

[目的]通过对辽宁省胃癌高低发地区居民的基本情况、生活习惯、饮食因素和生物因素分布进行对比调查,探讨胃癌发病相关危险因素。[方法]在辽宁省胃癌高低发区各随机选择一个村,共280名调查对象,对随机抽取研究对象按高低发区分组进行流行病学调查及采集标本,分析两组调查对象各项指标差异。[结果]每天摄入玉米类食物、每周摄入3次以上动物性脂肪为胃癌的危险因素;每天摄入面类食物、每周摄入1次以上豆类及其制品、每周摄入3次以上植物性脂肪为保护性因素。[结论]调整农村居民膳食结构,增加面类食品,减少玉米类食品的摄入,增加豆类及制品的摄入,增加植物性脂肪,减少动物性脂肪,可能对降低辽宁省农村地区胃癌的发病有一定意义。     

Gastric Cancer: the Roles of Diet,Alcohol Drinking,Smoking and Helicobacter pylori in Northeastern Thailand

The incidence of gastric cancer in the countries of South East Asia is variable, ranging from age-standardized ‍rates of 20.9/105 (men) and 10.4/105 (women) in Hanoi, Vietnam to 4.1/105 (men) and 2.1/105 (women) in Khon Kaen, ‍Thailand. The reasons for these differences are unknown. Possible explanations are differences in dietary habits, ‍alcohol drinking, smoking and/or the prevalence of infection with Helicobacter pylori (H. pylori). A case-control ‍study was conducted in Khon Kaen, Thailand, to study the role of these factors in gastric cancer carcinogenesis. 131 ‍gastric cancer cases and 262 matched controls were recruited for the study. Information on dietary habits, alcohol ‍drinking and smoking were collected by a structured questionnaire. Blood samples were available from 111 cases ‍and 232 controls for H. pylori assay. Using an unconditional logistic regression model controlling for age and sex, we ‍assessed the effects of dietary habits, alcohol drinking, smoking and H. pylori infection on the risk of gastric cancer. ‍A high intake of salt (OR=1.8; 95%CI 1.1-3.0) and fermented foods (OR=1.9; 95%CI 1.1-3.3) was found to be ‍associated with an increased risk. Preference for spicy food was not associated with gastric cancer risk in this ‍population. Although there were negative associations between gastric cancer and vegetable and fruit intake, they ‍were rather weak (OR 0.8 for both) and non significant. There were also weak (non-significant) associations with ‍smoking and alcohol consumption, and no association with H. pylori infection (OR=0.6; 95%CI 0.4-1.0). Infection of ‍H. pylori was associated with various indicators of crowding. ‍     

Sodium intake, salt taste and gastric cancer risk according to helicobacter pylori infection, smoking, histological type and tumor site in china

Aim: The risk factors mostly strongly associated with gastric cancer are gastric bacteria Helicobacter pyloriand diet. Using a case-control study among residents in Jinan, we examined the association between the salt tasteand gastric cancer according to H. pylori infection, smoking and histological type as well as tumor site. Methods:This population-based case-control study included 207 cases and 410 controls. Data on potential risk factors ofgastric cancer were obtained by interview of cases and controls with a questionnaire, salt taste preference wasmeasured for all subjects, and IgG antibodies to H. pylori were applied to assess infection. Risk measures weredetermined using unconditional logistic regression. Results: The proportions of salt taste at intervals of 1.8-7.2g/L and ≥7.2 g/L were significantly higher in cases than controls, with ORs of 1.56 (1.23-3.64) and 2.03 (2.12-4.11), respectively, subjects with high salt intake having an elevated risk for gastric cancer when infected withH. pylori. Significant modification by smoking and tumor site was observed across the different measures of saltintake, the highest salt taste showed higher cancer risk in ever smokers or with non-cardia cancers. Conclusion:Our study supports the view that high intake of sodium is an important dietary risk factor for gastric cancer,with a synergistic effect found between salt and H.pylori and smoking, dependent on the tumor site.     

Diet and gastric cancer in Portugal--a multivariate model.

Diet and gastric cancer mortality in Portugal was studied using a multivariate ecological model. The factors investigated over 18 districts were the relationship between gastric cancer mortality (1994-96), dietary habits, and socio-economic factors (1980-81). Mortality geographical pattern was established using age-standardized mortality rates, per capita dietary consumption of foodstuffs and nutrients was obtained from the National Alimentary Survey (1980-81), and data on socio-economic factors from the 1981 National Census. Pearson correlation coefficients and simple and multiple linear regression models were used. The mortality geographical pattern resembled a north-south gradient, and dietary habits and socio-economic factors had great variability throughout the country. The highest negative correlation coefficients between dietary consumption and gastric cancer mortality were obtained for vegetables, fruit, vitamin A and carotene consumption, and the highest positive coefficients were for rice, wine and carbohydrate consumption. No significant correlations were obtained for socio-economic factors. In multiple regression analysis, vegetable and rice consumption could account for 79% of the gastric cancer mortality variability for males, and vegetable and meat consumption could account for 69% of this variability for females. Interestingly, meat consumption was found to be protective. A mean increase of 100 g/person/day in vegetable consumption would imply a mean predicted decrease of 10 (95% CI 6-14) and 5 (95% CI 3-7) gastric cancer deaths per 100,000 persons/year, for males and females respectively, in simple regression analysis. Such a decrease represents about one-third of the mean national gastric cancer mortality rate. Therefore, an increase in vegetable consumption is strongly recommended.     

A case-control study of gastric cancer and diet in northern Kyushu, Japan

A case-control study of gastric cancer was done in a rural area of northern Kyushu, Japan, in relation to dietary habits especially focusing on the relationship with the consumption of broiled fish. The study was based upon 139 cases of newly diagnosed gastric cancer at a single institution, 2,574 hospital controls and 278 controls sampled randomly from the residents of the study area (with sex and year of birth matched). No association was observed between the consumption of broiled fish and gastric cancer risk whether three types of broiled fish (raw fish, dried fish and salted fish) were analyzed separately or as a single category. However, consistently in the comparisons with both sets of controls, the risk of gastric cancer was inversely related with the consumption of fruits and positively associated with cigarette smoking. A decreased risk of gastric cancer was also noted among those with high consumption of green tea (10 or more cups per day).     

Fruit and vegetable consumption,Helicobacter pylori antibodies,and gastric cancer risk: A pooled analysis of prospective studies in China,Japan, and Korea

Epidemiological findings on the association between fruit and vegetable consumption and gastric cancer risk remain inconsistent. The present analysis included 810 prospectively ascertained non‐cardia gastric cancer cases and 1,160 matched controls from the Helicobacter pylori Biomarker Cohort Consortium, which collected blood samples, demographic, lifestyle, and dietary data at baseline. Conditional logistic regression adjusting for total energy intake, smoking, and H. pylori status, was applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for gastric cancer risk across cohort‐ and sex‐specific quartiles of fruit and vegetable intake. Increasing fruit intake was associated with decreasing risk of non‐cardia gastric cancer (OR = 0.71, 95% CI: 0.52–0.95, p trend = 0.02). Compared to low‐fruit consumers infected with CagA‐positive H. pylori, high‐fruit consumers without evidence of H. pylori antibodies had the lowest odds for gastric cancer incidence (OR = 0.12, 95% CI: 0.06–0.25), whereby the inverse association with high‐fruit consumption was attenuated among individuals infected with CagA‐positive H. pylori (OR = 0.82, 95% CI: 0.66–1.03). To note, the small number of H. pylori negative individuals does influence this finding. We observed a weaker, nondose‐response suggestion of an inverse association of vegetable intake with non‐cardia gastric cancer risk. High fruit intake may play a role in decreasing risk of non‐cardia gastric cancer in Asia.     

A Case-Control Study of Gastric Cancer and Diet in Northern Kyushu, Japan

A case-control study of gastric cancer was done in a rural area of northern Kyushu, Japan, in relation to dietary habits especially focusing on the relationship with the consumption of broiled fish. The study was based upon 139 cases of newly diagnosed gastric cancer at a single institution, 2,574- hospital controls and 278 controls sampled randomly from the residents of the study area (with sex and year of birth matched). No association was observed between the consumption of broiled fish and gastric cancer risk whether three types of broiled fish (raw fish, dried fish and salted fish) were analyzed separately or as a single category. However, consistently in the comparisons with both sets of controls, the risk of gastric cancer was inversely related with the consumption of fruits and positively associated with cigarette smoking. A decreased risk of gastric cancer was also noted among those with high consumption of green tea (10 or more cups per day).     

Geographic and social class variation within the UK in levels of salivary nitrates and nitrites. A preliminary report

In the study, the first results of which are reported here, salivary nitrate and nitrite levels were examined in populations drawn from regions of the UK which differ in mortality rates for gastric cancer. The aims were to see, firstly, whether there was an equivalent geographic variation for nitrate and nitrite levels and, secondly, whether within each region any socio-economic or dietary characteristics correlated with the salivary levels. The results show that the nitrate and nitrite levels are significantly higher in residents from the Oxford region (low gastric cancer incidence area) than in residents from the north-east of England and north Wales (high-incidence areas). Further, within each area there is a noticeable relationship between nitrate and nitrite levels and age and social class. The social class trend is, as with the geographic trend, the inverse of that for stomach cancer risk. It is felt that the explanation of these results is probably a greater consumption of fresh, nitrate-containing vegetables by people in the Oxford region and by those in higher socio-economic groups. The implications that these results have for the nitrate hypothesis in relation to gastric cancer is discussed.     

Gastric carcinogenesis: diet as a causative factor

Gastric cancer is a very typical cancer related to life styles, including nutrition and dietary conditions. Cigarette smoking has also been pointed out as an enhancing factor in gastric cancer development. Improvement of dietary conditions, regular dietary habits including lower salt, nitrite and nitrite intake and balanced nutritious food may be factors suppressing the incidence of gastric cancer. At the same time, advances in technology for early diagnosis and early surgical treatment have elevated the cure rate of gastric cancers. From both primary and secondary cancer prevention aspects, gastric cancer is now a conquerable disease.