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 population-based matched case-control study on the risk factors of gastric cardia cancer

Objective To find the major risk factors associated with gastric cardia cancer.Methods We selected five high incidence areas of esophageal cancer and gastric cancer which have cancer registration system,i.e.Cixian and Shexian of Hebei Province,Linxian of Henan Province,Feicheng of Shandong Province and Zhuanghe of Liaoning Province.Fifty newly diagnosed cases of cardiac cancer after January 1,2008 were selected from each cancer registration database.A uniform questionnaire,which was fully consulted by experts,was used.Population-based 1∶3 case-control study was conducted in those areas.The study recruited 250 cases of cardiac cancer and 750 matched controls,which were investigated with the uniform questionnaire.The data were statistically analyzed by fitting-conditional Logistic analysis.Results Smoking,passive smoking,alcohol drinking,irregular meal,improper dining posture,heavy taste,dried food,pickled food,fried food,hot food,gastrointestinal history,gastroesophageal reflux disease(GERD)can increase the risk of cardiac cancer.To eat more bean and high BMI are protective factors of the single factor logistic analysis.Gastrointestinal history(OR=42.899),dried food(OR=5.932),irregular meal(OR=4.911),hot food(OR=4.144),pickled food(OR=3.287),passive smoking(OR=2.355),and GERD(OR=1.930)can increase the risk of cardiac cancer,eat more bean(OR=0.254)and BMI≥25(OR=0.492)are protective factors of the mixture factors logistic analysis.Conclusions Gastric cardia cancer is caused by environmental risk factors and genetic factors.Health education in high cardiac cancer incidence areas and primary prevention popularized into people's daily life will be beneficial to decreasing the incidence of gastric cardia cancer.