上海市区胃癌危险因素探讨

目的 探索上海市区胃癌的危险因素，为采取有效的预防措施提供科学依据。方法 采用全人群病例对照研究，共调查1999年4月～1999年10月期间诊断的30～74岁的上海市区新发胃癌病例311例(男性198例，女性113例)，对照1579例，获得环境暴露等资料。采用非条件logistic模型控制混杂因素计算各个因素的调整比值比(OR)和95％可信限(95％CI)。结果 男性中吸烟、热烫饮食、油炸面食、患病前精神压抑和自我调节能力差、慢性胃炎及一级亲属胃癌史等因素可增加患胃癌的危险性；女性胃癌则与腌制食品(尤其是腌制蔬菜)、油炸食品、酒精摄人、患病前精神压抑和自我调节能力差、溃疡病史、慢性胃炎史及一级亲属胃癌史等关系密切。新鲜蔬菜、水果，新鲜豆类，豆制品，植物油和蛋及蛋制品等对胃癌有保护作用。调整可能的混杂因素后，分析结果均达到显著水平。结论 上海市区胃癌近十年危险因素没有明显改变，吸烟、腌制食品和油炸食品、慢性胃炎史和胃癌家族史等可能是主要的危险因素，而多食新鲜蔬菜和水果、豆及豆制品等对胃癌有保护作用。     

上海市区饮食与胃癌病例对照研究

1988年12月1日～1989年11月30日在上海市区进行了基于全人群的胃癌病例对照研究。调查了1197例病人和1451例对照,年龄均在20～69岁。总结了胃癌与饮食的关系。胃癌与饮食关系单因素研究结果表明,高盐饮食、三餐不按时、进餐速度快、过饱饮食等因素增加胃癌的危险性,年龄调整OR值男性组分别为2.08、4.17、2.22和2.00;女性组分别为5.00、4.10、2.08和1.81;男性油炸食品及女性腌制食品摄入增加,提高了胃癌的危险性,OR值分别为2.47和2.97。植物类食品如新鲜蔬菜、鲜豆类、豆及豆制品、根茎类食品以及新鲜水果的摄入频度与胃癌存在负相关的关系;动物类食品如淡水鱼、禽蛋、奶及奶制品和鸡鸭肉的每月摄入频度增加也可降低胃癌的危险性,男性组表现更为明显。在Logistic多因素研究中发现,维生素C和维生素A对胃癌有较强的保护作用,进入模型的因素还有三餐不按时、过饱饮食、高盐饮食、热烫饮食、油炸食品等。在研究中还发现,文化程度愈低,胃癌的危险性愈大。     

中国人群饮食因素与肝癌发病关系的Meta分析北大核心CSCD

目的探讨中国人群饮食因素与肝癌发病的关联性,为制定防治措施提供科学依据。方法系统检索2016年5月前国内外发表的有关中国人群饮食因素与肝癌相关性的文献资料,对各因素与肝癌发病关系的OR值及95%CI进行统计分析。结果最终纳入46篇文献,累计病例11 613例,对照为12726例,葱蒜类、豆制品、蔬菜类、水果类、茶类、鱼类因素合并的OR值及95%CI均<1;干硬食品、高盐饮食、禽蛋类、霉变食品、烟熏食品、腌制食品、酒类、肥肉、生鱼类因素合并的OR值及95%CI均>1;动物肉类、油炸食品、酸醋食品与肝癌的无关。结论在中国人群饮食因素中,摄入葱蒜类、豆制品、蔬菜类、水果类、茶类、鱼类可能为肝癌的保护因素;摄入干硬食品、高盐饮食、禽蛋类、霉变食品、烟熏食品、腌制食品、酒类、肥肉类、生鱼类饮食可能为肝癌的危险因素;动物肉类、油炸食品、酸醋食品与肝癌的关联尚不能确定。     

宁夏海原县胃癌癌前病变危险因素分析

目的:探讨宁夏海原县胃癌癌前病变可能的危险因素,为预防胃癌提供相应依据。方法:以2018年1月至2019年1月于宁夏海原县人民医院和宁夏回族自治区人民医院宁南医院行胃镜检查的5 280例患者为筛选对象,将通过胃镜检查诊断为萎缩性胃炎,经病理诊断为肠化、异型增生的患者作为病例组。将同期行胃镜检查诊断为非萎缩性胃炎,经病理诊断无肠化、无异型增生的患者,按照1∶1配对作为对照组。用单因素、多因素非条件二元Logistic回归方法进行分析。结果:病例组与对照组单因素分析提示在体质量指数（BMI）、居住坏境、教育程度、吸烟、饮酒、饮绿茶、饮水来源、新鲜蔬菜、新鲜水果、肉蛋奶、豆类食品、腌制食品、油炸食品、烫热食品、大蒜、吃早餐、进食不规律、消化疾病史、幽门螺杆菌（Hp）感染、非甾体抗炎药服用史、睡眠时间因素方面差异均有统计学意义（P＜0.05）。通过Logistic回归分析模型分析提示吸烟、饮酒、饮用地窖水、腌制食品、油炸食品、烫热食品及Hp感染是胃癌癌前病变发生的危险因素。而较高的教育程度、饮绿茶、新鲜蔬菜、新鲜水果、吃早餐、7~8 h睡眠时间是胃癌癌前病变的保护因素。结论:影响宁夏海原县胃癌癌前病变的因素是多方面的,Hp感染、腌制、油炸和烫热食品及饮用地窖水是当地发生胃癌癌前病变最重要的危险因素。所以改变生活习惯,根除Hp是预防宁夏海原县发生胃癌癌前病变的重要措施。     

吸烟、饮酒与胃癌关系的病例对照研究

目的 探讨吸烟、饮酒与胃癌发生的关系。方法 采用全人群病例对照研究,共调查1999年4月－1999年10月期间诊断的上海市区新发胃癌病例311例,对照1579例（注：本课题为“九五”中乳腺癌、肺癌及胃癌病例－对照之一,对照共用）。采用非条件logistic回归分析,调整可能的混杂因素,以估计吸烟、饮酒对胃癌发生的比数比和95％的可信区间。结果 吸烟与男性胃癌发生有关,调整OR为1．67（95％CI：1．14－2．460,并且随着吸烟年龄的提前（P＜0．01）、吸烟年限的延长（P＜0．05）、每日吸烟量的增加（P＜0．05）和吸烟包－年（P＜0．01）,患胃癌的危险性显著增大;未发现女性吸烟与胃癌发生有显著性联系。进一步调整整烟,发现饮酒与胃癌无密切关系,但重度饮酒可能与女性胃癌发生有关。进一步研究饮酒的作用,分析吸烟与饮酒状况及吸烟支数与酒精克数不同剂量分层之间的交互作用,调整年龄、文化程度（仅女性）、腌制食品、新鲜水果及慢性胃炎后,发现男性饮酒与吸烟不同剂量之间有交互作用存在,交互项χ^2值为5．20,P＝0．02,即饮酒增加男性吸烟者患癌的危险。结论 进一步证实吸烟是胃癌发生的危险因素;单独饮酒与胃癌发生无明显关系,饮酒不是胃癌的一项独立危险因素;饮酒增加吸烟患胃癌的危险,两者有协同作用。     

中国人群饮食因素与食管癌Meta分析

[目的]研究中国人群饮食因素与食管癌的关联。[方法]对国内2000～2005年发表的21项关于食管癌饮食因素的病例对照研究文献中的饮食因素进行Meta分析。累计病例5759例,对照8795例。[结果]腌制食品、饮食不规律、霉变食品、喜烫食、高盐饮食、进餐速度快、酸菜的合并OR值及其95%CI均大于1,分别为2.79(1.85～4.20)、2.76(2.42～3.14)、2.53(2.16～2.95)、2.51(1.75～3.60)、2.27(1.35～3.82)、2.17(1.61～2.92)、1.71(1.16～2.54);饮茶、水果、豆及豆制品的合并OR值及其95%CI均小于1,分别为0.25(0.21～0.30)、0.46(0.44～0.48)、0.50(0.31～0.79);而葱蒜、动物肉类、禽蛋、辛辣食品、蔬菜、油炸食品与食管癌之间的关联无统计学意义。[结论]在中国人群的饮食因素中,腌制食品、饮食不规律、霉变食品、喜烫食、高盐饮食、进餐速度快、酸菜是食管癌的危险因素,饮茶、水果、豆及豆制品是食管癌的保护因素。     

江苏省肿瘤低发地区主要恶性肿瘤相关影响因素配对病例对照研究

目的：探讨江苏省恶性肿瘤低发地区主要肿瘤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以人群为基础的肿瘤1：1配对病例对照研究，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：食管癌和胃癌的共同危险因素为进食快、热烫饮食和癌症家族史；对于肺癌而言，规律吸烟年龄早（OR=3．63）、烟龄长（OR=4．13）和吸进部位深（OR=2．79）均能增加患病概率；饮茶是食管癌（OR=0．73）、胃癌（OR=0．37）、肺癌（OR=0．60）和肝癌（OR=0．27）的共同保护因素，而生吃大蒜对食管癌（OR=0．68）和胃癌（OR=0．64）的保护作用比较确切。结论：在人群中倡导戒烟限酒，克服不良的膳食习惯，能够有效预防上消化道肿瘤和肺癌的发生。     

女性乳腺癌危险因素的病例对照研究

[目的]探讨江苏女性乳腺癌的危险因素。[方法]用病例对照研究的方法,对经病理确诊的206例乳腺癌患者及经年龄频数匹配（±2．5岁）214例对照资料进行非条件Logistic回归分析。[结果]被动吸烟（OR=2．21,95％CI：1．32～3．701、自然流产史（OR=1．71,95％CI：0．65—4．55）、口服避孕药服用史（OR=3．70,95％CI：2．00～6．82）、有良性乳腺疾病史（OR=2．69,95％CI：1．66～4．36）、肥猪肉（OR=2．39,95％CI：1．34～4．28）及腌制类食品年摄入量高（OR=4．71,95％CI：2．91～7．60）、轻体力活动职业（OR=6．29,95％CI：2．95～13．42）可能是女性乳腺癌发生的危险因素。而经常参加体育锻炼（OR=0．44,95％CI：0．26～0．74）、月经初潮年龄晚（OR=0．19,95％CI：0．06—0．65）、鲜奶（0R=0．32,95％CI：0．20～0．511、新鲜豆类（0R=0．07,95％CI：0．04—0．13）和水果年摄入量高（OR=0．30,95％CI：0．18—0．48）则降低乳腺癌发生的风险。[结论]减少口服避孕药、肥猪肉及腌制类食品的摄入,增加新鲜水果、新鲜豆类摄入,加强体育锻炼,对患有良性乳腺疾病的妇女加强体检。加大乳腺癌预防及健康宣教工作可预防乳腺癌的发生。     

生活习惯和饮食与胃癌发生的相关性研究

目的：探讨生活习惯和饮食等危险因素与胃癌发生的关系。方法：采用病例对照研究，胃癌患者97例，非胃癌肿瘤患者77例为对照组，调查患者的一般情况、既往史及家族史、饮食摄入情况、生活居住环境以及饮酒和吸烟史等，饮食部分的调查采用频数法。对资料进行单因素和多因素非条件Logistic回归分析。结果：单因素分析结果，饮酒、吸烟年限长、有胃癌家族史和喜吃腌制食物是胃癌的危险因素，OR值分别为2．456、2．333、3．060和1．959；清淡、酸性食物、喝绿茶和喝茶年限超过20年是胃癌的保护性因素，OR值分别为0．402、0．297、0．402和0．331；多因素分析结果，腌制食物、吸烟年限长、胃癌家族史是胃癌的危险因素，而清淡饮食和喝茶年限长是胃癌的保护性因素。结论：腌制食物、吸烟年限长和胃癌家族史可增加胃癌的发病风险，而清淡饮食和喝茶年限长可降低胃癌发生的危险性。     

贲门癌发病危险因素的病例对照研究

目的 探讨贲门癌发病的危险因素.方法 选择食管癌高发区河北省磁县、河北省涉县、河南省林州市、山东省肥城市及胃癌高发区辽宁省庄河市,每个地区选择2008年1月以后发病的贲门癌50例.采用以人群为基础的1∶3配对病例对照研究,用专门设计的调查表,分别对250例患者和750例对照进行问卷调查.并采用SPSS 13.0软件COXREG命令拟合条件Logistic回归模型,对相关变量进行分析.结果 单因素分析显示,吸烟、饮酒、饮食不规律、就餐姿势不正确、饮食口味重、常吃干果干菜、腌制食品、油炸食品、热烫食品、消化系统疾病史、胃食管反流性疾病可增加贲门癌发病的危险性,多吃豆类食品、体质指数(BMI)≥25则为保护因素.多因素分析显示,消化系统疾病史、常吃干果干菜、饮食不规律、常吃烫热食品、常吃腌制食品、吸烟、胃食管反流性疾病是贲门癌发病的危险因素,比值比(OR)分别为42.889、5.932、4.911、4.144、3.287、2.355和1.930;常吃豆类食品、BMI≥25是贲门癌发病的保护性因素,OR值分别为0.254和0.492.结论 生活行为习惯是贲门癌发病的重要影响因素,在高发区人群中开展健康教育,干预其不良生活行为和饮食习惯,将有助于降低贲门癌的发病率.     

A Case Control Study on Risk Factors for Stomach Cancer in Urban Shanghai

Objective To examine the possible risk factors for stomach cancer among men and women in Shanghai, China. Methods In urban Shanghai, in-person interviews were completed for 311 cases newly diagnosed with stomach cancer of ages 30 -74. Data were collected from April 1999 to October 1999 and compared to 1579 population-based controls (controls in three cancer studies used together). Information on demographic variables, smoking, diet consumption and others was collected from all subjects. Unconditional logistic regression was used to adjust the possible factors. Results Stomach cancer risk in men rose with smoking, eating hot and fried foods, chronic gastritis and a family history of gastric cancer among men; the risk among women was associated with the consumption of preserved, pickled and fried foods, heavy drinking, chronic gastritis, a history of ulcer disease and a family history of gastric cancer. A dose-response relationship was found (trends test,P<0.01) among men smokers. In contrast, the consumption of fresh vegetables and fruits, beans (especially soybeans) and soy products, plant oil, and eggs and egg products, was inversely associated with stomach cancer risk. After adjustment of the potential confounding variables, these associations remained significant. Conclusions The present findings provide further evidence that smoking, eating salted foods (especially salted vegetables), oil-fried foods(including fried cereal, eggs, and peanuts), chronic gastritis, a family history of gastric cancer and so on increase the risk of stomach carcinoma in Shanghai. Fresh vegetables and fruits, beans and soybean products (even after adjusted for use of fresh vegetables and fruits), plant oil, and so on may have protective effects.     

胃癌低发区的病例对照研究

目的 :探寻肿瘤低发区胃癌的危险因素和保护因素。方法 :选择江苏省胃癌低发区邳州市胃癌患者 187例进行病例对照研究 ,以普通人群为对照。结果 :咸肉、熏肉、咸鱼、剩粥、油炸食物的摄入与胃癌危险性增加有关 ,前三者OR值分别为 2 36、3 4 4和 6 4 7。而新鲜蔬菜、豆类的摄入与胃癌发生的危险性呈负相关 ,OR值分别为 0 5 1和 0 5 3。多食大蒜亦趋于降低胃癌危险性。结论 :经常摄入咸肉、熏肉、咸鱼、剩粥、油炸食物是胃癌的危险因素 ,摄入新鲜蔬菜、豆类、大蒜则是胃癌的保护因素。     

Risk factors of stomach cancer

The risk factors for stomach cancer are reviewed. A family history of stomach cancer, smoking habit, highly salted foods and Helicobacter pylori are risk factors, while fresh vegetables, fruits and green vegetables are preventive ones. Stomach cancer may arise mainly from moderately but not severely atrophic gastric mucosa, where atrophic change is ongoing. New strategies for primary and secondary prevention of stomach cancer should be built utilizing these recent findings.     

Diet and stomach cancer incidence. A case-control study in Turkey

A case-control study of diet and stomach cancer was conducted in Ankara, Turkey, between December 1987 and March 1988. One hundred patients with adenocarcinoma of the stomach were matched with 100 control subjects according to age, sex, and residential area. A dietary questionnaire was administered to all subjects by one of the authors. Gastric cancer patients consumed less fresh fruit and yellow-green vegetables (P less than 0.0001) and meats (P less than 0.001), and more salted food (P less than 0.001), condiments (P less than 0.0001), and salt (P less than 0.001) compared with the control group. Twenty-four percent of the gastric cancer patients and 4% of the groups with regard to the consumption of starches, fried foods, cereals, milk, dairy products, tea, alcohol, and tobacco. Stomach cancer patients brushed their teeth less frequently (P less than 0.0001) and had more deficient teeth (P less than 0.0001) compared with the control group.     

饮食因素与女性乳腺癌危险性的病例对照研究

[目的]探讨各类饮食因素与女性乳腺癌危险性的关系。[方法]采用以人群为基础的病例对照研究,调查上海市1999年4月至10月间确诊的乳腺癌患者(n=356)和全人群对照(n=925)的一般情况和饮食摄入情况等,采用量化食物摄入频度问卷调查表估价之前5年内的食物摄入情况。[结果]经调整潜在混杂因素后多因素分析发现,以最低摄入量组作参照,新鲜豆类每月平均摄入量在1773g~3748g、>3748g者患乳腺癌的危险性显著下降,OR值(95%CI)分别是0.63(95%CI=0.43~0.93)和0.61(95%CI=0.41~0.91),并有剂量效应关系(P<0.01)。其中毛豆、其他新鲜豆类分别和乳腺癌危险性呈负相关(P<0.01,P=0.04)。将每年摄入量按四分位法分组后,以最低剂量组作参比,随着腌晒类食品和油炸食品摄入量的增加女性患乳腺癌的危险性也增加(趋势检验P=0.02,P=0.01)。[结论]新鲜豆类对女性乳腺癌具有保护作用,而各类腌晒食品和油炸食品特别是油炸鱼/肉、油炸面食以及油煎花生米可增加女性乳腺癌的危险性。     

Risk factors for esophageal cancer in Shanghai,China. II. Role of diet and nutrients

A population-based case-control study of esophageal cancer (902 cases, 1,552 controls) in Shanghai, China, investigated the etiologic role of diet. After adjustment for cigarette smoking, alcohol consumption and other risk factors, increasing consumption of fruits, dark orange vegetables and beef or mutton was associated with statistically significant decreasing trends in risk for esophageal cancer. In general, risks were about 40% lower among those in the upper vs. lower quartiles of intake of these foods. Fivefold increases in risk were observed among those who consumed burning hot soup or porridge, with smaller excesses for preserved vegetables, salty and deep fried foods. Nutrient analysis revealed that increased dietary intake of protein, carotene, vitamins C and E and riboflavin was associated with reduced esophageal cancer risk. Our findings support the notion that the reported temporal increases in the per capita consumption of fruits, vegetables and animal products contribute to the substantial reduction in the incidence of esophageal cancer in Shanghai, particularly since cigarette and alcohol use has not decreased.     

Dietary factors and gastric cancer in Korea: a case-control study.

To assess gastric cancer (GC) risk in relation to dietary intake in Korea, a case-control study was performed. Trained dietitians interviewed 136 patients diagnosed with GC, and the same number of controls were selected by matching sex, age and hospital. A significant decrease in GC risk was observed with increased intake of Baiechu kimchi (prepared with salted Chinese cabbage and red pepper, etc.), Baiechu kimchi-stew, garlic, mushroom and soybean milk. On the contrary, a significant increase in the risk of GC was observed with increased intake of cooked rice with bean, charcoal grilled beef, pollack soup, Kkakduki (a kind of kimchi prepared with salted radish and red pepper, etc.), Dongchimi (a kind of kimchi prepared with radish and a large quantity of salt water) and cooked spinach. In food groups, increased intake of soybean products was associated with decreased risk of GC. Intake of citrus fruits rather than total fruits was shown to have a protective effect on the risk of GC, but was not significant. In this study, intake of total vegetables was shown to have a protective effect, whereas high nitrate-containing vegetables increased the risk of GC. In conclusion, our study suggests that the risk of GC decreased with high consumption of fresh vegetables and fruits, whereas high consumption of foods rich in nitrate and carcinogenic substances produced during the cooking process increased the risk of GC.     

Geographical difference of mortality of digestive cancers and food consumption

The geographical differences in mortality from cancer of seven sites of the digestive organs and consumption of foods in 46 of the prefectures, excluding Okinawa and their capital cities were statistically observed. The groups of foods statistically associated with cancer death are: pork, cooking oil and shochu (low class distilled spirits) for esophageal cancer; fresh fish, salted fish, vegetables and alcoholic beverages for stomach cancer; alcoholic beverages, salted or dried fish, vegetables, bread, milk, butter, margarine, ketchup, beer and fresh fish for colonic cancer; fresh fish, salted or dried fish, salt and popular grade sake for rectal cancer; pork, popular grade sake and green tea for cancer of the biliary passages; salted or dried fish, vegetables, alcoholic beverages, oil and fresh fish for pancreatic cancer; beef, poultry, eggs and vinegar for liver cancer. Further epidemiological analyses are required to find the biological causal relationships.     

Dietary factors and stomach cancer mortality

The present study examined the relationship between stomach cancer and the low intake of fresh fruit and vegetables and/or a high intake of pickled, preserved or salted foods and frequent use of cooking oil. During 139,390 person-year of follow-up of over 13,000 subjects, 116 died from stomach cancer. Using a Cox proportional hazards-regression analysis of relative risk (RR, 95% CI) controlling for age, sex, smoking and other dietary factors, a significant decline was found with a high consumption of green and yellow vegetables (RR=0.4, 95% CI=0.2-0.9). Reductions of between 40 and 50% were also observed with a high consumption of fresh foods (fruit, cuttle fish, tofu, and potatoes), but these associations were not statistically significant. The risk was significantly increased by the high consumption of processed meat (RR=2.7, 95% CI=1.0-7.4) and by the frequent use of cooking oil (RR=4.0, 95% CI=1.3-11.8). The high consumption of pickled food and traditional soups also increased risk, but not significantly. The findings suggest that a diet high in salt and low in vitamins may be associated with an increase in stomach cancer.     

A case-control study of gastric cancer and diet in Italy

A case-control study was conducted in high- and low-risk areas of Italy to evaluate reasons for the striking geographic variation in gastric cancer (GC) mortality within the country. Personal interviews with 1,016 histologically confirmed GC cases and 1,159 population controls of similar age and sex revealed that the patients were more often of lower social class and resident in rural areas and more frequently reported a familial history of gastric (but not other) cancer. After adjusting for these effects, case-control differences were found for several dietary variables, assessed by asking about the usual frequency of consumption of 146 food items and beverages. A significant trend of increasing GC risk was found with increasing consumption of traditional soups, meat, salted/dried fish and a combination of cold cuts and seasoned cheeses. The habit of adding salt and the preference for salty foods were associated with elevated GC risk, while more frequently storing foods in the refrigerator, the availability of a freezer and use of frozen foods lowered risk. Reduced GC risk were associated with increasing intake of raw vegetables, fresh fruit and citrus fruits. Lowered risk was also related to consumption of spices, olive oil and garlic. Neither cigarette smoking nor alcoholic beverage drinking were significantly related to GC risk. The case-control differences tended to be consistent across geographic areas, despite marked regional variations in intake levels of certain foods. The high-risk areas tended to show higher consumption of food associated with elevated risk (traditional soups, cold cuts) and lower consumption of foods associated with reduced risks (raw vegetables, citrus fruits, garlic). Our findings indicate that dietary factors contribute to the regional variation of stomach cancer occurrence in Italy, and offer clues for further etiologic and prevention research.