云南锡矿工肺癌的队列研究

目的；建立矿工肺癌队列，探讨云锡矿工肺癌的危险因素，为肺癌早期标志物研究和肺癌防治研究提供基础。方法：以特殊人群为基础的前瞻性研究，每年用痰检和胸部X线对高危云锡矿工进行肺癌筛查，建立动态队列，分析氡、砷暴露等因素与肺癌的关系，并收集痰脱落细胞、胸片和其它生物样本。结果；1992－1999年间共有9143人进入队列，发现460例肺癌新病例，进行了47655人次胸部X线检查和46625人次痰检，年龄调整慢性支气管炎、硅肺和吸烟暴露RR分别为1．73、1．46和1．32。结论：成功建立了云锡职业暴露队列。作氡、砷暴露是该高危人群肺癌的危险因素外，慢性支气管炎、硅肺和吸烟也与肺癌发病有关。

Establishment of cohort to study lung cancer in Yunnan tin miners

Objective To establish a cohort for the study of risk factors of lung cancer, and to support the study of early biomarkers and prevention of lung cancer. Methods Designed a special population-based prospectively dynamic cohort among radon- and arsenic-exposed tin miners aged 40 or more years old with at least 10 years of occupational exposure in Yunnan Province, P.R.China. The mass screenings with sputum cytology and chest X-ray were conducted annually. The baseline information was collected for assessing demographic characteristics and risk factors. The multiple sputum specimens, chest radiographs and numerous biologic specimens have been collected and stored. Results From 1992--1999, 9?143 miners have been enrolled and 460 new cases of lung cancer have been found. There had 47?655 person-time chest radiographs and 46?625 person-time sputum cytology among the cohort in 8 years. The relative risks of age-adjusted exposure to chronic bronchitis, silicosis, and tobacco were 1.73, 1.46, and 1.32 respectively. Conclusion A cohort of unique occupationally-exposed tin miners with an extensive biologic specimen repository and data bank has been successfully established. Although occupational exposures are the predominant risk factors among the high risk miners, lung cancer risk is also associated with chronic obstructive lung disease (chronic bronchitis and silicosis) and a number of measures of exposure to tobacco smoke, including early age of first use, duration, and cumulative exposure.