被动吸烟与宫颈癌关系的Meta分析

目的 利于Meta分析的方法系统评价被动吸烟与宫颈癌的关系.方法 检索2000～2009年Elsevier、中国期刊网、万方数据知识平台等已经发表的关于被动吸烟和宫颈癌关系研究的文献.纳入标准为涉及被动吸烟和宫颈癌关系的病例对照研究,各文献研究方法相似,有综合的统计指标.剔除不符合纳入标准,且重复研究报告及数据不完整的文献.利用Review Manager 4.2软件进行统计分析.结果 将14个研究结果加权合并,累计病例2 612例,累计对照3 050例,被动吸烟与宫颈癌有关联(Z=4.34,P<0.0001),合并计算的OR=1.62,其95%CI:1.30～2.01.结论 被动吸烟是宫颈癌发生的一个危险因素.     

孕妇被动吸烟与小于胎龄儿关系的Meta分析

目的 探讨孕妇孕期被动吸烟与小于胎龄儿之间的关系,分析不同孕期和不同地点被动吸烟的效应.方法 利用Meta分析方法综合分析国内外8篇关于孕妇孕期被动吸烟与小于胎龄儿关系的回顾性研究文献.结果 孕妇孕期被动吸烟与小于胎龄儿之间的粗合并效应值OR=1.45(95%CI:1.05～2.01),调整合并效应值OR=1.76(95%CI:1.15～2.69);孕妇孕早期被动吸烟的合并效应值OR=1.85(95%CI:1.25～2.72),孕中晚期被动吸烟的合并效应值OR=2.12(95%CI:1.43～3.13);家庭和工作中被动吸烟与小于胎龄儿之间的关系均没有统计学意义.结论 孕妇孕期被动吸烟可增加发生小于胎龄儿的危险性.除了家庭和工作环境外,还应注意其他环境的被动吸烟.     

孕妇被动吸烟与低出生体重关系的Meta分析

目的分析孕妇孕早期和不同孕期被动吸烟对新生儿低出生体重的影响。方法通过Meta分析方法分析孕妇被动吸烟与新生儿低出生体重之间的关系。对NCBI、OVID-MEDLINE、CNKI、VIP以及CBM数据库进行检索(截止日期为2008年4月),结果报告合并OR值及95%CI。结果共获得26篇文献,其中队列研究20篇,病例对照研究6篇。总体分析,孕妇被动吸烟的合并效应值OR=1.65(95%CI:1.39～1.97);调整合并效应值OR=1.60(95%CI:1.25～2.05);最低和最高暴露量的合并效应值分别为OR=1.53(95%CI:1.14～2.04)和OR=2.53(95%CI:1.46～4.36);孕早期暴露的合并效应值OR=1.12(95%CI:0.82～1.55),没有统计学意义。结论孕妇被动吸烟增加新生儿低出生体重的危险性;孕中晚期可能是被动吸烟效应的敏感期;被动吸烟的阈值是否存在尚不明确。     

BMI与宫颈癌发病风险的Meta分析

目的 探讨BMI与宫颈癌发病风险的关系。方法 采用系统评价方法,在EMbase、The Cochrane Library、PubMed、CNKI、WanFang Data和VIP数据库上,检索BMI与宫颈癌发病关系的文献,检索时限均从建库至2019年5月,整个过程由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata 12.0软件进行Meta分析。结果 共纳入15个研究,共计1 178 773名研究对象。Meta分析结果显示:超重人群患宫颈癌的风险是正常体重人群的1.10倍（OR = 1.10,95％CI:1.04～1.16,P = 0.001）,肥胖人群患宫颈癌的风险是正常体重人群的1.34倍（OR = 1.34,95％CI:1.16～1.55,P＜0.001）,差异均有统计学意义。结论 超重和肥胖均会增加宫颈癌发病风险,超重与宫颈癌发病风险之间的相关性较弱,但肥胖与宫颈癌发病风险之间有显著的相关性。     

吸烟与脑膜瘤关系的荟萃分析

目的通过系统回顾和荟萃分析研究吸烟与脑膜瘤的相关关系。方法在线检索与主题相关的研究文献,对符合条件的研究进行质量评价和数据提取,采用Stata 12.0软件进行荟萃分析。结果共纳入符合条件的研究文献12篇。Meta分析结果显示脑膜瘤病组与对照组人群中吸烟率的优势比差异无统计学意义(OR=1.03,95%CI:0.95~1.12,P=0.513),男性(OR=1.22,95%CI:1.00~1.49,P=0.046)与女性(OR=0.89,95%CI:0.80~1.00,P=0.046)脑膜瘤病组与对照组之间吸烟率的差异均有统计学意义。在平均每天吸烟包数!烟龄≥13时,脑膜瘤病组与对照组人群中吸烟率的优势比差异有统计学意义(OR=1.20,95%CI:1.04~1.38,P=0.011),男性脑膜瘤病组与对照组之间吸烟率的差异有统计学意义(OR=1.40,95%CI:1.10~1.77,P=0.006),而女性无统计学差异(OR=1.02,95%CI:0.85~1.22,P=0.85)。分别以研究类型(病例对照研究/队列研究)、研究种族、对照人群来源进行亚组分析,结果显示,曾经吸烟与脑膜瘤之间的关联无统计学差异,P0.05。结论根据现有资料表明,曾经吸烟与脑膜瘤发生没有相关性,而长期大量吸烟有可能是脑膜瘤发生的危险因素之一,对于男性尤为显著,对女性来说,曾经吸烟可能是脑膜瘤发生的一个保护性因素,长期大量吸烟没有相关性。     

被动吸烟与儿童哮喘关系的Meta分析

目的:探讨被动吸烟与儿童哮喘的关系。方法:采用ReviewManager4·2分析软件,对国内外15篇有关被动吸烟与儿童哮喘关系的病例对照结果进行了随机效应模型的Meta分析。结果:被动吸烟与儿童哮喘的发生关联明显(Z=4·93,P<0·00001),合并OR值为1·51,OR95%CI为1·28~1·77。结论:被动吸烟是儿童哮喘发生的一个危险因素。     

河南省三门峡地区宫颈癌患者危险因素调查分析

目的探讨河南省三门峡市宫颈癌患者的危险因素,为宫颈癌的预防提供依据。方法采用病例对照研究方法选取2010-2015年河南省三门峡市4所医院诊治的185例宫颈癌患者作为病例组,另选取同期门诊健康体检人群330例作为对照组。对所有研究对象进行问卷调查,采用SPSS 17.0统计软件对数据进行条件Logistic回归分析,从而筛选该地区宫颈癌的危险因素。结果 185例患者中,宫颈癌主要发生在30~50岁之间,已婚、初中以下文化程度、农民和卫生资源缺乏的女性宫颈癌发病率较高;HPV感染(OR=29.127,P0.01),首次性交年龄(OR=4.583,P0.01),性伴侣个数(OR=4.119,P0.01)和流产次数(OR=4.211,P0.01)与宫颈癌的发生显著相关。吸烟(OR=2.856,P0.01),生产次数(OR=2.952,P0.01),配偶有包茎(OR=2.015,P0.01)和配偶有阴茎癌或者前列腺癌(OR=1.654,P0.01)与宫颈癌的发生也有相关性。而绝经(OR=0.501,P0.01)和使用避孕套(OR=0.634,P0.01)为宫颈癌的保护因素。结论 HPV感染是河南省三门峡地区宫颈癌高发的主要危险因素,首次性交年龄早、性伴侣个数多、流产次数多、吸烟、配偶包茎和前列腺癌均与宫颈癌发生呈正相关,而绝经和使用避孕套能降低宫颈癌的发生率。     

孕期吸烟与先天性腹裂胎儿关系的Meta分析

[目的]探讨孕期吸烟与先天性腹裂胎儿的关系,分析不同孕期和每天不同吸烟量对先天性腹裂的影响。[方法]分别检索6个中英文文献数据库,选择6篇符合纳入标准的文献,通过Review Manager 4.2和Stata软件进行Meta分析。[结果]孕期吸烟与先天性腹裂胎儿之间的合并效应值为OR=2.36（95%CI：2.02～2.76）;每天吸烟量为10～20支及〉20支的合并效应值分别为OR=2.29（95%CI：1.89～2.77）和OR=2.54（95%CI：1.68～3.85）,吸烟量〈10支的无统计学意义;孕期前三个月吸烟的合并效应值为OR=2.46（95%CI：1.52～3.98）。[结论]孕期吸烟尤其孕期前三个月吸烟与先天性腹裂胎儿具有显著相关性,此相关性随每天吸烟量的增加而增大。     

孕产期环境因素与儿童孤独症关系的Meta分析

目的探讨围孕、产期高危环境暴露与孤独症的关系,为前期预防与早期干预提供科学依据。方法利用RevMan5.3软件,对国内2006~2016年儿童孤独症高危因素的病例对照研究资料进行Meta分析,计算合并的优势比(OR)和95%置信区间(CI),评估发表偏倚并对各项结果进行敏感性分析。结果本次研究共纳入文献15篇,累计病例1 551例,对照1 753例。孕产期各危险因素的合并OR及其95%CI分别为:孕期疾病史OR=5.19,95%CI:3.61~7.46;孕期情绪OR=3.36,95%CI:2.25~5.05;孕周异常OR=4.19,95%CI:2.95~5.96;出生缺氧或窒息OR=4.37,95%CI:2.71~7.05;孕期有毒化学物接触OR=2.92,95%CI:1.92~4.43;高龄产妇OR=2.03,95%CI:1.59~2.58;主、被动吸烟OR=2.20,95%CI:1.60~3.03;遗传史OR=5.41,95%CI:3.08~9.50。结论 Meta分析结果显示,中国儿童孤独症的患病可能与孕期疾病史、孕期情绪、孕周异常、出生缺氧或窒息、孕期有毒化学物接触、高龄产妇、主、被动吸烟和遗传史相关。     

宫颈癌相关影响因素病例对照研究

目的 了解宫颈癌的相关影响因素,为预防宫颈癌发病提供科学依据.方法 采用以医院为基础病例对照研究方法对2007年9月-2010年6月在福建省厦门市妇幼保健院、厦门市第一医院和厦门市中医院就诊的112例宫颈癌患者及同期就诊的200例其他疾病女性患者进行宫颈癌相关影响因素问卷调查并检测血中维生素B12及叶酸含量.结果 单因素Logistic回归分析结果表明,首次性生活年龄(OR=0.659)、首次生育年龄[OR=0.715)、叶酸含量(OR=0.386)、维生素B12含量(OR=0.661)、经常饮茶(OR=0.596)、被动吸烟(OR=1.738)、性行为时注意卫生(OR=0.483)、分娩次数(OR=1.904)是宫颈癌发病的相关影响因素;多因素Logistic回归分析结果表明,分娩次数＞2次和被动吸烟是宫颈癌发病的危险因素;叶酸含量≥10 nmol/L、经常饮茶和性生活时注意卫生是宫颈癌发病的保护因素.结论 有多次分娩史和被动吸烟的妇女患宫颈癌的危险性较大;性行为时注意卫生、经常饮茶、补充叶酸可预防宫颈癌的发生.     

Cigarette smoking and cervical cancer: meta-analysis and critical review of recent studies.

The objective of this study is to investigate the strength of the epidemiological evidence for a relationship between smoking and cervical cancer by analysis of recent literature. I conducted a meta-analysis of all eligible case-control studies published in English from 1977 to July 1990, with the primary intent of examining the relationship between smoking and cervical cancer. I identified nine eligible studies. Data pooled from eight studies using similar definitions for cervical cancer and classification of smoking showed a significant effect on cervical cancer of ever having smoked, with a crude odds ratio (OR) of 1.46 (95% confidence interval [CI] 1.34-1.58). And, from those studies which adjusted for age and number of sexual partners, a weighted OR of 1.42 (95% CI 1.33-1.51) was obtained. A significant association between smoking and cervical cancer emerges. Data from these studies suggest a 42%-46% increase in cervical cancer among smokers, even after controlling for age and number of sexual partners.     

HLA-A Alleles and the Risk of Cervical Squamous Cell Carcinoma in Japanese Women

Background

We conducted a case-control study to examine the relationship between human leukocyte antigen-A (HLA-A) allele polymorphism and the pathogenesis of cervical neoplasia among Japanese women.

Methods

A total of 119 patients with invasive cervical squamous cell carcinoma were compared to 119 age- and menopausal status-matched non-cancer controls. Blood samples were taken from all cases and controls and lifestyle information was collected by means of a self-administered questionnaire. The estimated impact of HLA-A alleles on cervical cancer risk was evaluated by unconditional logistic regression models.

Results

The frequency of HLA-A*0206 among cases was significantly lower than among controls (P = 0.006). There was an inverse association between A*0206 and cervical cancer risk (odds ratio [OR] = 0.31, 95% confidence interval [95% CI] = 0.15 to 0.65, P = 0.002), and a positive association for HLA-A*2402 (OR = 1.76, 95% CI = 1.00 to 3.09, P = 0.048). After correction for multiple comparisons, A*0206 was significantly associated with reduced cervical cancer risk (corrected P = 0.036). Furthermore, the inverse association between A*0206 and cervical cancer risk was independent of smoking status (never smoker: OR = 0.37, 95% CI = 0.15 to 0.90; ever smoker: OR = 0.23, 95% CI = 0.06 to 0.89).

Conclusions

There was an inverse association between HLA-A*0206 and cervical cancer risk among Japanese women, which suggests that HLA-A polymorphism influences cervical cancer risk. Further investigation in other populations is thus warranted.Key words: cervical cancer, human leukocyte antigen, case-control study     

Sexual activity, contraception, genital infections, and cervical cancer: support for a sexually transmitted disease hypothesis

A case-control study was conducted in Utah between 1984 and 1987 to examine risk factors for cervical cancer. Interviews were completed with 266 histologically confirmed carcinoma in situ and invasive squamous cell cervical cancer cases who were categorically matched by age to 408 controls. Among the factors identified as altering risk for cervical cancer, after adjustment for age, education, church attendance, and cigarette smoking, were: having numerous sex partners (odds ratio (OR) = 8.99 for 10 or more partners); the current mate having several sex partners (adjusted OR for 10 or more partners = 8.62); using foam or jelly as a contraceptive method (OR, adjusted for number of sex partners, = 0.44); reported Trichomonas infection (OR, adjusted for number of sex partners, = 2.10); and herpes simplex virus type 2 infection as determined by 2:1 neutralization index values above 100 (OR = 2.70). A protective effect was noted from the use of diaphragms (OR = 0.67) or condoms (OR = 0.53) in women who reported more than one sex partner. These data support the hypothesis that cervical cancer is a sexually transmitted disease.     

Clinical and demographic predictors of late-stage cervical cancer

BACKGROUND: Despite increasingly widespread use of the Papanicolaou smear, almost half of all women with invasive cervical cancer are diagnosed at a late stage (regional or distant). Little is known about factors associated with late-stage diagnosis of cervical cancer. OBJECTIVE: To examine the relationship of age, race, education level, income level, smoking, marital status, health insurance type, comorbidity, and residence in an urban or rural setting to late stage at diagnosis of cervical cancer. METHODS: Incident cases of invasive cervical cancer occurring in 1994 in Florida were identified from the state tumor registry (N = 852). Cases were linked with state discharge abstracts and the 1990 US census. Multiple logistic regression was used to determine the relationship between predictor variables (age, race or ethnicity, marital status, smoking status, education level, income level, insurance type, comorbidity, and urban vs rural residence) and the odds of late-stage diagnosis. RESULTS: Age, marital status, and insurance type were associated with late-stage diagnosis. Each additional year of age was associated with a 3% increased odds of late-stage diagnosis (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05; P<.001). Being unmarried was associated with a 63% increased odds of late-stage diagnosis (OR, 1.63; 95% CI, 1.18-2.25; P=.003). Being uninsured was associated with a 60% increased odds of late-stage diagnosis (OR, 1.60; 95% CI, 1.07-2.38; P=.02). Having commercial health maintenance organization insurance was associated with a 46% decreased odds of late-stage disease (OR, 0.54; 95% CI, 0.30-0.96; P=.04). Race, education level, income level, smoking status, comorbidity, and urban residence were not associated with stage at diagnosis. CONCLUSIONS: Women with cervical cancer who are elderly, unmarried, and uninsured are more likely to be diagnosed at a late stage. These women should be targeted for cervical cancer education and screening programs.     

Cigarette smoking and alcohol consumption in the aetiology of uterine cervical cancer

A case-control study of uterine cervical cancer was conducted using 331 cases and 993 age-matched controls identified through the Missouri Cancer Registry during 1984-1986. Patients with smoking- or alcohol-related cancers were excluded from the control series. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (Cls) after adjustment for age, cigarette smoking, alcohol consumption, and stage at diagnosis. A dose-response relation was observed between intensity of cigarette smoking and invasive cervical cancer, with light and heavy smokers having elevated risks (OR = 2.2, 95% Cl = 1.4-3.6 and OR = 3.9, 95% Cl = 2.7-5.6, respectively). Former smokers had less elevated risk (OR = 1.7, 95% Cl = 1.0-2.9), a finding consistent with a greater effect of tobacco smoke on late-stage carcinogenesis. Similar results were obtained in age- and control site-specific analyses. Further, the age-specific data suggested a dose-response relation between duration of smoking and invasive cervical cancer. An association between alcohol consumption and invasive cervical cancer was not observed.     

Lung cancer and smoking in Asturias,Spain. A case-control study

OBJECTIVE: Lung cancer in Asturias is 1.4-fold greater than the Spanish average, while the proportion of smokers is similar. The objective of this study was to examine the relationship between lung cancer and smoking in Asturias. MATERIAL AND METHODS: We performed a hospital-based, incident case control study. The cases were newly diagnosed lung cancer patients and controls were patients from the surgical wards. Information was sought on smoking, occupational exposures, and demographic variables. The analysis was performed by means of odds ratios (OR). RESULTS: One hundred ninety-seven cases and 196 controls were included in the analysis. The adjusted OR of cigarette smoking was 5.77 (95% CI, 2.96-11.22). The risk increased with the number of cigarettes smoked per day (chi 2 = 56.3), the number of packs/year (chi 2 = 48.4), and the age at which smoking started (chi 2 = 76.5). The OR diminished with the number of years of cessation (chi 2 = 39.9). CONCLUSIONS: The relationship between smoking and lung cancer in Asturias is similar to that found in other studies carried out in other parts of the western world. The magnitude of the OR may explain the frequency of lung cancer in Asturias. Greater efforts should be devoted to controlling this problem.     

The role of contraceptive use in cervical cancer: the Maryland Cervical Cancer Case-Control Study

Recent evidence on the importance of sexual history and sexually transmissible agents in cervical cancer has been reported. Case-control studies have frequently demonstrated increased risk of cervical cancer for women using oral contraceptives, while laboratory results have shown that vaginal spermicides inactivate various sexually transmissible agents. To determine the role of contraceptive use in cervical cancer, 153 cases of Maryland women with invasive cervical cancer and age, race, and residence-matched controls were interviewed in 1985, focusing on sexual history, health care utilization patterns, screening history, contraceptive use, and smoking. Overall, lifetime use of contraceptives was protective of cervical cancer (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.2-0.7). Use of oral contraceptives (OR = 0.48), diaphragm (OR = 0.29), and vaginal spermicides (OR = 0.28) were more frequent in controls than cases. After adjustment for behavioral factors (age at first intercourse, smoking, gaps in Papanicolaou smear testing, and obstetrician-gynecologist visits), use of vaginal spermicides remained significant (OR = 0.30), although use of oral contraceptives and barrier methods of contraception failed to remain significant. The effectiveness of vaginal spermicides in preventing cervical cancer may be due to their antiviral action.