食管病变影响因素的多项式Logistic回归分析

目的探讨食管癌家族史、吸烟和饮酒与食管炎症、增生、早期癌间的关联。方法在食管癌高发社区40-69岁队列人群中，将内镜检查正常者作为对照组，炎症、增生、早期癌患者分别作为病例组，所有病例均经染色内镜和病理活检确诊。采用多项式Logistic回归模型，将OR作为评价关联强度的指标。结果确诊早期癌71例、增生266例、炎症144例，食管黏膜正常2818例。有食管癌家族史与食管早期癌、增生、炎症均呈显著性相关；其中一级血亲患食管癌在3组的OR值分别为2．6（95％CI=1．36～4．85）．2．1（95％CI=1．43～2．99），1．8（95％CI=1．13～3．03），但二级血亲患食管癌在3组的OR值差异均无统计学意义。有食管癌家族史尤其是一级血亲患有食管癌者吸烟或／和饮酒能显著增加食管癌的危险性。结论在食管癌高发区，有食管癌家族史者应戒烟酒，以预防食管良恶性疾病的发生。

Multinomial logistic regression for influence factors of esophageal lesions

Objective To investigate the associations of family history of esophageal cancer,smoking and drinking to esophagitis,esophageal hyperplasia and early cancer.Methods In a high incidence community of esophageal cancer,a cohort of residents aged from 40 to 69 were examined for the esophageal lesions.The people with normal esophageal mucosa determined by gastric endoscopy served as controls,and the 3 disease groups respectively consisted of patients with esophagitis,esophageal hyperplasia and early cancer diagnosed by staining endoscopy and pathogenic examination.OR was used as the association indicator to analyze the multinomial regression result.Results Seventy-one cases of esophageal early cancer,266 of esophageal hyperplasia,144 of esophagitis,and 2818 of normal esophageal mucosa were found in the mass screening.Family history of esophageal cancer was significantly associated with all the three kinds of esophageal lesions.The OR for esophageal cancer history of first-degree relatives was 2.6(95%CI=1.36-4.85),2.1(95%CI=1.43-2.99)and 1.8(95%CI=1.13-3.03)in early esophageal cancer,hyperplasia,and esophagitis groups respectively,but no significant OR level was found in all the three groups for esophageal cancer history of second-degree relatives.Smoking or/and drinking increased the risk of having esophageal cancer to those whose relatives especially first-degree relatives had esophageal cancer histories.Conclusion In high-incidence areas of esophageal cancer,abstinence from smoking and drinking alcohol may prevent esophageal lesions for persons with family history of esophageal cancer.