饮食与胆囊癌关系的流行病学研究

目的探讨饮食因素与胆囊癌发病的关联,为采取预防措施提供科学依据.方法采用全人群病例对照研究,研究对象为1997年6月～2001年5月期间确诊的、年龄在35～74岁的上海市区368例胆囊癌新发病例以及按性别、年龄(5岁一组)频数配对的895例人群对照.采用非条件logistic回归模型分析饮食各因素与胆囊癌的关系.结果女性中,与最低四分位数组相比,葱属类蔬菜年摄入次数最高四分位组的调整OR为0.55(95%CI:0.31～0.97;Ptrend=0.06);与不吃组比较,大蒜头和洋葱最高摄入组的调整OR分别为0.59(95%CI:0.34～0.99;Ptrend=0.03)和0.52(95%CI:0.30～0.91;Ptrend=0.01).与最低四分位组比较,腌制品摄入其余各组调整OR在女性中依次为1.06、1.88、2.31,Ptrend＜0.001;与不吃乳腐组比较,余三组的调整OR依次为1.19、1.47、1.88,Ptrend＜0.01.男性结果与女性类似,腌制品和葱属类蔬菜摄入的各组OR都有不显著的升高和降低.结论新鲜蔬菜,尤其是葱属类蔬菜对胆囊癌的保护作用在女性比男性明显,而且以大蒜头、洋葱的保护作用较为显著.而腌制品摄入,尤其是乳腐,可能会增加胆囊癌的发病风险.

Diet and risk of gallbladder cancer: a population-based case-control study

Objective To explore the relationship between dietary factors and the risk of gallbladder cancer. Methods A population-based case-control study was conducted in urban Shanghai from June 1997 to May 2001 involving interviews with 368 incident cases of gallbladder cancer aged of 35 to 74 years and 895 population controls frequency-matched to cases by gender and age in five-year groups. An unconditional logistic regression was performed to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results Women in the highest quarter intake of total allium vegetables had a statistically significant lower risk of gallbladder cancer(OR= 0. 55, 95%CI:0. 31-0. 97; Ptrend=0. 06) than those in the lowest quarter. Comparison with the non-intake group showed reduction in risk for women in the highest intake group for garlic (OR = 0. 59, 95%CI: 0. 34-0. 99; Ptrend = 0.03) and onion (OR = 0.52, 95%CI: 0.30-0.91; Ptrend=0. 01). Compared with women with the lowest quarter of intake of preserved foods, the adjusted odds ratios of gallbladder cancer were increased from 1. 06 to 1. 88 and 2. 31 with increasing quarter of intake (Ptrend<0. 001). Similar results were observed for intake of allium vegetables and preserved foods among men, although not statistically significant. Conclusion Allium vegetables, especially garlic and onion intake may have protective effect against gallbladder cancer, and the effect was more pronounced for women than for men. However, preserved foods intake appeared to be associated with an increased risk of gallbladder cancer.