吸烟、饮酒、体质量指数和食管鳞状细胞癌发病风险分析

目的探讨吸烟、饮酒、体重指数与食管鳞状细胞癌(esophageal squamous carcinoma,ESCC)发病风险的关系。方法采用流行病学调查的病例-对照研究方法,病例组4 229例均经组织病理学确诊,对照组4 133例均经内镜检查排除了早期ESCC和其他上消化道肿瘤,全部调查资料输入EXCEL表中,进行统计分析。结果吸烟、饮酒与ESCC发生无明显关联;经性别、诊断年龄、高低发区、家族史等因素调整后Logistic回归分析表明,低体重(I级BMI)人群ESCC发病风险高于正常体重者(II级BMI)(P<0.05,OR=4.87,95%CI=4.09～5.82);超重及肥胖(III+IV级BMI)人群ESCC的发病风险低于正常体重者(II级BMI)(P<0.05,OR=0.32,95%CI=0.28～0.37)。结论 ESCC的发生与吸烟、饮酒无关,与体重指数有关,低体重可能增加ESCC患病风险。

Correlation of body mass index,smoking and alcohol drinking with the risk of esophageal squamous cell carcinoma

Objective To correlate body mass index,smoking and drinking with the risk of esophageal squamous cell carcinoma(ESCC).Methods With a large population epidemiological case-control study,4229 patients were confirmed with ESCC by histopathology.4133 subjects in control group were free of early ESCC or other upper gastrointestinal malignant diseases based on endoscopic examination.All information of cases with ESCC and subjects in control group were recorded into EXCEL form,and were enrolled into final analyses based on clinical data.Results Smoking and alcohol drinking had no significant association with ESCC in China Han population.After adjusting age at diagnosis,gender,high-and low-incidence areas and family history and so on,the result of logistic regression analysis revealed that underweight(Grade I) shows a higher risk of ESCC than that with normal range BMI(Grade II)(P<0.05,OR=4.87,95% CI=4.09~5.82);overweight(Grade III) and obesity(Grade IV) shows a lower risk of ESCC than those with normal range BMI(Grade II)(P<0.05,OR=0.32,95% CI=0.28~0.37,).Conclusion Smoking and alcohol drinking had no significant association with ESCC in China Han population.BMI was associated with ESCC.Underweight may increase the risk of ESCC.