南京市肺癌环境危险因素的病例对照研究

目的探讨近年来南京市肺癌发生的环境危险因素.方法对南京市63例原发性肺鳞癌和89例原发性肺腺癌进行1:1配对病例-对照研究,并用条件Logistic回归模型分析危险因素.结果慢性支气管炎史、吸烟指数是肺鳞癌发生的环境危险因素,其OR值分别为8.55,2.35;人群归因危险度分别为18.22%,58.80%;综合人群归因危险度为0.6871.慢性支气管炎史、肺结核史、不良烹调习惯、煤炉使用年限、家族肿瘤史是肺腺癌发生的环境危险因素,OR值分别为5.16,4.12,2.91,2.02,2.59;人群归因危险度分别为8.15%,11.91%,27.30%,29.98%,10.35%;综合人群归因危险度为0.630 6.结论肺鳞癌、腺癌的发病分别与多种环境因素有关,应积极控制环境危险因素,以减少肺癌的发生率.     

原发性肺腺癌危险因素性别差异分析

为分析不同性别原发性肺腺癌的危险因素，本文对南京市１８０例（男性１００例，女性８０例）原发性肺腺癌进行了配对病例对照研究。条件Ｌｏｇｉｓｔｉｃ多因素模型分析结果表明，烹调油烟污染、慢性支气管炎疾患史、肿瘤家族史等为男女性别肺腺癌发生的共同危险因素。其相对危险度（ＲＲ）对男性分别为２．８４、２．３０、４．８９。对女性分别为３．２０、３．２３、４．２３，另外，男性肺腺癌的发生尚与吸烟有关，ＲＲ为１．０１，女性肺腺癌的发生则与冬季煤炉采暖有关，ＲＲ为２．２９。本文尚分别对各危险因素进行了人群归因危险度的估计。     

广东省肺癌危险因素病例对照研究

对广东省３９０例肺癌作１：１病例对照研究，比较不同性别、不同病理类型肺癌的危险因素。女性肺癌的流行特征、病理类型、危险因素与男性肺癌不尽相同。２９１例男性肺癌以肺鳞癌多见（鳞癌：腺癌＝１：０．５），９９例女性肺癌以肺腺癌为主（鳞癌：腺癌＝１：２．７）；女性肺癌诊断时年龄明显比男性小（Ｐ〈０．００１）。单因素Ｌｏｇｉｓｔｉｃ回归分析发现，家族肿瘤史、家族肿癌史、慢支／肺气肿病史、肺结核史、其他肺疾患     

吸烟与膀胱癌关系的病例对照研究

对１１０例膀胱癌住院病例进行了病例对照研究。结果显示吸烟者有显著升高的膀胱癌危险度（ＯＲ＝２．１３，９５％ＣＩ为１．１８～３．８４），尤其吸烟年限在４０年以上者，其危险度高达４．１０倍。开始吸烟年龄越小危险性越大，并随着吸烟年限、吸烟量、吸烟深度的增加而增加，随戒烟年限的增加而减小，呈明显的剂量－反应关系。经年龄调整后，吸烟致膀胱癌的人群归因危险度为４２％。吸烟与危险职业暴露对膀胱癌的发生有交互作用，其相对超额危险度为４．６８。     

女性非吸烟者中被动吸烟与肺癌关系的探讨

为了探索非吸烟者中肺癌发病原因，采用病例对照的方法对北京市ＳＩＮＯ－ＭＯＮＩＣＡ项目监测人群中的肺癌病例进行了调查，分析结果显示被动吸烟与非吸烟女性患肺癌有一定阳性关联（ＯＲ＝２．５２，Ｐ＜０．０５），并随被动吸烟年支的增加而上升，当达２００年支以上时有显著统计学意义（Ｐ＜０．０５）。环境香烟烟雾（ＥＴＳ）诱发肺腺癌的可能性较大（ＯＲ＝２．３２，Ｐ＜０．０５），而与肺鳞癌似无关系（ＯＲ＝１．０４，Ｐ＜０．０５）。     

煤矿区居民女性乳腺癌发病危险因素的研究

为研究煤矿区居民女性乳腺癌的发病危险因素，１９９１年至１９９４年间，在河南省平顶山矿区开展一次１：２配比的病例对照病因研究。对研究因素进行了单因素与多因素的统计分析。多元条件Ｌｏｇｉｓｔｉｃ回归分析表明该人群主要的发病危险因素为：乳腺良性疾病史、生育胎数少、月经紊乱及乳腺癌家族史。它们相应的调整人群归因危险度分别为０．１４８７、０．４７８１、０．１２８２、０．０７９１，四因素综合人群归因危险度为０．６９５２．     

吸烟、被动吸烟与肺癌发病风险的病例对照研究

目的 探讨吸烟、被动吸烟与肺癌的关联.方法 采用病例对照研究设计,面访肺癌新发病例1 303例和按性别、年龄(±2岁)频数匹配的健康对照1 303例.结果 吸烟是男性肺癌的重要危险因素(调整OR=4.974,95％ CI:3.933 ～6.291),随着开始吸烟年龄提前、吸烟年限延长、日吸烟量、吸烟包年以及吸烟深度的增加,患肺癌危险性增高,呈剂量反应关系(Ptrend＜0.001),戒烟≥10年患肺癌的危险性降低45.4％.男性吸烟患肺鳞癌的危险性比患肺腺癌大.被动吸烟是非吸烟者肺癌的危险因素(调整OR=1.912,95％CI:1.486～2.460),工作环境被动吸烟的男性非吸烟者患肺癌的调整OR为2.221(95％CI:1.361 ～3.625),家庭环境被动吸烟的女性非吸烟者患肺癌的调整OR为1.804(95％ CI:1.270～2.562).68.04％男性肺癌的发生可归因于吸烟,26.51％非吸烟者肺癌的发生可归因于被动吸烟.结论 吸烟是肺癌的重要危险因素,工作环境被动吸烟是男性非吸烟者肺癌的主要危险因素,家庭环境被动吸烟是女性肺癌的主要危险因素.戒烟具有重大的公共卫生学意义.     

肺鳞癌的预后因素分析

肺鳞癌的预后因素分析中国医科大学病理学教研室（１１０００１）中国医科大学流行病教研室李建华朱继江周宝森肺鳞癌是我国男性肺癌的主要类型，在北方占５６％〔１〕，吸烟是其主要的危险因素〔２〕。有关肺鳞癌预后因素的研究，虽有报道〔３〕，但因方法欠妥，单因素分...     

非吸烟肺腺癌患者肺癌组织中MGMT基因启动子区超甲基化水平高于吸烟的肺腺癌患者

背景和目的：在美国的肺癌患者中，腺癌是最普遍，在吸烟人群中超过了40％，而在非吸烟人群中占50％-80％。在吸烟和非吸烟者中，主动吸烟或被动吸烟和氡的衰变产物的放射性是造成肺腺癌的主要危险因素。本研究目的是在一个患有中央型和外周型肺腺癌的人群中(吸烟者157例、非吸烟者46例、既往铀矿工人34例)中检测MGMT启动子区甲基化的分布情况，并分析MGMT的甲基化与K—ras基因第12密码子突变间的关系。方法：从石蜡包埋的肺癌组织块中提取基因组DNA，采用嵌合式双阶段甲基化特异性聚合酶链反应的方法评价MGMT启动子区的甲基化程度，采用限制性片段长度多态性的方法分析K—ras基因第12密码子的基因突变。     

中国农民胃癌危险因素联合作用危险度研究

运用多因素条件下的人群归因危险度（ＰＡＲ）研究和评价了１３个危险因子在中国农民胃癌发生上的联合作用，估计其调整人群归因危险应（ＰＡＲＣ）和综合人群归因危险度（ｓＰＡＲ）．结果表明：在胃癌发病作用上（ＯＲ值）以饮塘沟水（３．６２）、性情急躁（３．３３）和生气吃饭（３．２５）的因素危险最大；调整人群归因危险度（ＰＡＲｃ）以精神心理、饮水及饮食行为因素的比例占主导地位。１３个危险因素致癌联合作用的综合人群归因危险度（ｓＰＡＲ）为９１．１５％．而其它因素所发生的致病效应估计不超过８．８５％．探讨和研究在多因素条件下有关因素危险度的联合作用对于病因学的解释和公共卫生实践具有重要意义．     

上海市徐汇区女性肺癌病例对照调查

All the 57 female lung cancer patients in Xu-Hui District, Shanghai discovered during 1985 were used as subjects of this study, each was matched with 2 of her near neighbours of same sex and within 5 years of age difference. Smoking, chronic bronchitis, pulmonary tuberculosis and family history of tumour were found to be related with lung cancer in single variable analysis. Upon stratification, smoking and pulmonary tuberculosis were still found related to lung cancer and considered as risk factors with OR and its 95% confidence interval 6.996, 3.23-15.14 and 4.82, 1.37-19.97 respectively. But chronic bronchitis failed to relate with lung cancer and was considered as a confounding factor. Of all the female lung cancer cases only 49.1% and 19.3% were smokers and TB patients respectively, hence smoking and TB could be responsible only for a small portion. In cancer cytology, squamous-cell carcinoma appeared to show association with smoking while adenocarcinoma did not. Among female lung cancer cases the proportion of adenocarcinoma exceeded that of squamous-cell carcinoma, and appeared unrelated with smoking. More family members of the lung cancer cases seem to have had malignant histories, suggesting that a hereditary factor of cancer susceptibility might be involved.     

病因分值在病例对照研究中的应用──肺癌危险因素的交互效应

对广东省２００例原发性女性肺癌的现患病人作１：１配对病例对照研究，在Ｍａｎｔｅｌ－Ｈａｅｎｓｚｅｌ分层分析和条件ｌｏｇｉｓｔｉｃ回归分析的基础上，探讨女性肺癌危险因素的病因分值以及被动吸烟与其他各种危险因素间的交互效应。多因素条件ｌｏｇｉｓｔｉｃ回归分析结果显示：被动吸烟，厨房通风，喜吃咸食，慢性支气管炎、家庭肿瘤史，肺结核，。服和避孕药是女性肺癌独立的危险因素。     

病因分值在病例对照研究中的应用──肺癌危险因素的交互效应

对广东省200例原发性女性肺癌的现患病人作1：1配对病例对照研究，在Mantel-Haenszel分层分析和条件logistic回归分析的基础上，探讨女性肺癌危险因素的病因分值以及被动吸烟与其他各种危险因素间的交互效应。多因素条件logistic回归分析结果显示：被动吸烟（丈夫）、厨房通风、喜吃咸食、慢性支气管炎史、家族肿瘤史、肺结核、服用避孕药是女性肺癌独立的危险因素（OR=2.16～40．55，P＜0．05）。它们的病因分值分别是0.535.0．432、0.252、0．124、0.115、0．072.0．069。分析被动吸烟（丈夫）与口服避孕药、家族肿瘤史、厨房通风、肺结核史、经常吃咸色或腌菜间交互作用，其病因分值分别为0．848、0．499、0．479、0.416、0．346.交互作用指数是0．906、0．543、0．578、0．427、0．441。研究提示被动吸烟是女性肺癌的重要危险因素，特别是丈夫吸烟，尤其是在与服用避孕药这一因素并存的情况下，增加女性肺癌的危险性。     

Smoking and lung cancer in China: combined analysis of eight case-control studies.

Smoking is well established as a principal risk factor for lung cancer. The risk of lung cancer is about ten times higher in smokers in Western countries. In China, a number of epidemiological studies have investigated the association between lung cancer and smoking and in the present paper, a combined analysis of eight such case-control studies is described. The summary odds ratio (OR), calculated by the Mantel-Haenszel method, and attributable risk (AR) of lung cancer associated with smoking were calculated from the combined data which were obtained from a literature review. The eight case-control studies were conducted in Beijing, Shanghai, Shenyang, Nanjing, Harbin, Zhengzhou, Taiyuan, and Nanchang, yielding a total of 4081 lung cancer cases and 4338 controls. The summary OR of lung cancer associated with smoking was 2.17 (95% CI (confidence interval): 1.98-2.39). The OR were 3.09 (95% CI: 2.61-3.66) for males and 2.30 (95% CI: 1.96-2.69) for females. The AR were 38.2% for both sexes, 56.7% for males and 25.5% for females. Risks of 1.00, 1.03, 2.04, and 3.33 showed a dose-response relationship between lung cancer and number of cigarettes smoked per day. There were also significant dose-response relationships of lung cancer with duration of smoking (OR = 1.00, 1.02, 2.66), and age at start of smoking (OR = 1.00, 3.30, 2.36, 1.18). The OR and AR of lung cancer associated with smoking in China were much lower than those reported in Western countries and the possible reasons for this are discussed.     

肺癌配对病例对照研究中烹调油烟等致病因子的多因素分析

This paper reports the study of 1:1 matched case-control for eighty-three cases of primary lung squamo-carcinoma and seventy-one cases of primary lung adenocarcinoma from urban districts of Nanjing. The result of conditional analysis reveals that cooking oil fume is a common risk factor for lung squamo-carcinoma and adenocarcinoma. Its relative risk and population attributable risk (%) are 3.8138, 3.4466 and 51.56%, 60.99% respectively. Besides, smoking, family history of tumors, fuel types and keeping warm by coal stove in winter are selected as risk factors for lung squamo-carcinoma, while history of chronic bronchitis and family history of tumors are screened as risk factors for lung adenocarcinoma. Summary population attributable risk for all five factors of lung squamo-carcinoma and all three factors of lung adenocarcinoma are 99.47% and 76.65% respectively.     

云锡矿工慢性支气管炎与肺癌关系的队列研究

目的探讨云锡矿工既往慢性支气管炎与肺癌的关系。方法利用前瞻性队列研究方法,分析云锡矿工肺癌高危人群慢性支气管炎与肺癌死亡危险的关系。结果1992—1999年,共9 295名云锡矿工进入队列,随访至2001年底,共443例肺癌死亡。慢性支气管炎可增加肺癌死亡危险性,调整危险比(HR)为1.5(95%CI:1.3～1.8),慢性支气管炎与肺鳞癌呈显著正相关,与腺癌和小细胞癌症的关联则无显著性。分层分析结果表明,两者关联仅在吸烟者中差异具有显著性。结论慢性支气管炎可能是云锡矿工肺癌死亡的危险因素之一,其致肺癌的危险应引起重视并加以控制。     

武汉市肺癌流行因素的多元Logistic回归分析

本文报道了1985年武汉市城区原发性肺癌的配对病例对照研究。共收集病例103人,对照206人。条件 Logistic 回归模型拟合结果表明,吸烟、被动吸烟、慢性支气管炎、胃病史及家族肿瘤史是肺癌发病的危险因素。吸烟量、被动吸烟量及患慢性支气管炎的年数与患肺癌的危险性之间存在着明显的剂量—效应关系。文中详细表述了各危险因素在 Logistic 模型中的回归系数、标准化回归系数及OR 值的大小。     

血小板衍生生长因子在肺鳞癌及肺腺癌中的表达及意义

目的　探讨血小板衍生生长因子 (PDGF)在肺鳞癌和肺腺癌中的表达及意义。方法　应用免疫组织化学技术观察了PDGF -A链和PDGF -B链在 42例肺鳞癌和 1 5例肺腺癌中的表达 ,并测定了它们在肺非特异性炎症组织中的表达。结果　PDGF -A链和PDGF -B链的表达主要定位于肿瘤细胞胞浆、血管内皮细胞及平滑肌细胞 ,炎症组织的肺泡上皮细胞及血管平滑肌细胞少量表达。PDGF -A链和PDGF -B链在肺鳞癌及肺腺癌中均有显著表达 ;PDGF的过度表达与肿瘤细胞的分化程度无关。结论　PDGF -A链和PDGF -B链的过度表达与肺鳞癌和肺腺癌有关 ;PDGF -A链和PDGF -B链的生物学特征可能有所不同 ,PDGF -B链与肿瘤微血管增生的关系可能更密切     

Previous pulmonary diseases and risk of lung cancer in Gansu Province, China

BACKGROUND: Although active smoking is well established as the main cause of lung cancer, there is accumulating evidence that history of prior lung diseases may be an independent risk factor for lung cancer. METHODS: A population-based case-control study in Gansu Province, China identified 886 lung cancer cases (656 male, 230 female) diagnosed between January 1994 and April 1998. A standardized interview collected information on a variety of potential risk factors including a history of physician-diagnosed non-malignant lung diseases (pulmonary tuberculosis, chronic bronchitis/emphysema, asthma, pneumonia), age and year in which each condition was first diagnosed, and any therapy or hospitalization received. RESULTS: Pulmonary tuberculosis (odds ratio [OR] = 2.1, 95% CI : 1.4-3.1) and chronic bronchitis/emphysema (OR = 1.4, 95% CI : 1.1-1.8) were associated with increased risk of lung cancer, after adjustment for active smoking and socioeconomic status. The OR for asthma (OR = 1.4, 95% CI : 0.9-2.1) and pneumonia (OR = 1.5, 95% CI : 1.0-2.3) were also elevated. The risk of lung cancer remained significant for pulmonary tuberculosis and chronic bronchitis/emphysema when analysis was limited to the pathologically confirmed cases and self-responders. CONCLUSIONS: This study provides additional evidence that previous pulmonary tuberculosis and chronic bronchitis/emphysema are causally related to lung cancer, although the precise mechanism is still unclear. The results for asthma and pneumonia, while suggestive of a positive association, did not reach the traditional level of statistical significance and should be interpreted with caution.     

Occurrence of pulmonary diseases in steel mill workers

The 'Sendzimir' Steel Mill, Cracow, Poland, gives employment to approximately 17,000 workers. During the years 1994-98, 1396 compensation claims for diseases related to occupational hazards were registered. After a scrupulous investigation, 851 cases were certified as occupation-related diseases. Of this number, 481 cases (56.5%) were diagnosed as pulmonary diseases, including silicosis (n = 225, 46.7%); chronic bronchitis (n = 138, 28.7%); lung carcinoma (n = 59, 12.3%); epithelial cancer (n = 42); adenocarcinoma (n = 12); microcellular carcinoma (n = 5); asthma, 12 atopic and 24 non-atopic (n = 36, 7.5%); and asbestosis (n = 23, 4.8%). Chronic bronchitis was diagnosed in patients exposed to industrial dusts, containing SiO2, NOx, and SO2. Asthma occurred most frequently among those exposed mainly to Cr+6, Co and Ni containing dusts, and lung carcinoma in those exposed to policyclic aromatic hydrocarbons, including benz(a)pyren, asbestos, chromium, vapours of oils and lubricants. In 1994-96, chronic bronchitis and silicosis, and in 1997-98, lung carcinoma and asthma were most frequently diagnosed in the workers under study. It is likely that the diminishing frequency of chronic bronchitis and silicosis was the consequence of technological progress, and greater concern for hygiene standards. Increasing incidence of lung cancer reflects long latency characteristic of this illness.