河北省居民食管癌发病影响因素病例对照研究

目的了解河北省食管癌发病的影响因素,为预防食管癌发病提供科学依据。方法采用以医院为基础病例对照研究方法对2009年6月-2011年5月在河北医科大学附属第四医院住院的208例食管癌患者及同期住院的210例非消化道疾病患者进行问卷调查。结果不同组别居民生活习惯情况比较,病例组与对照组居民在吸烟、饮酒、食用烫食、食用硬食、饮食速度、饮食时间、吃霉变食物、吃水果、吃新鲜蔬菜、吃豆类及其制品、吃奶类及其制品等生活习惯间差异均有统计学意义(P<0.05);病例组抑郁、愤怒、愤怒向内和理智平均得分分别为(44.30±7.47)、(24.74±6.71)、(14.71±2.51)和(42.19±6.50)分,分别高于对照组的(40.47±6.87)、(22.58±5.00)、(13.82±2.25)和(40.83±3.58)分(P<0.01);社会支持平均得分为(16.24±3.20)分,低于对照组的(17.53±2.13)分(t=4.867,P=0.000);多因素Logistic回归分析结果表明,居住在城镇和农村、有食管癌家族史、家庭人际关系一般、吸烟量≥20支/d、食用硬食、吃霉变食物以及理智、愤怒和抑郁得分高是河北省居民食管癌发病的危险因素;经常吃豆类及其制品、饮用自来水和社会支持得分高是河北省居民食管癌发病的保护因素;有食管癌家族史、吸烟量≥20支/d、食用硬食、吃霉变食物以及理智和愤怒得分高是男性居民食管癌发病的危险因素;经常吃豆类及其制品和社会支持得分高是男性居民食管癌发病的保护因素;食用烫食、食用硬食、抑郁得分高是女性居民食管癌发病的危险因素;饮用自来水、经常吃水果和社会支持得分高是女性食管癌发病的保护因素。结论河北省食管癌的发生与环境、饮食、吸烟、食管癌家族史及C型行为等有关,男女的影响因素有别,应根据具体情况采取有针对性的预防措施。

Influential factors of esophageal cancer in residents of Hebei province:a case-control study

Objective To examine influential factors of esophageal cancer among residents in Hebei province and to provide scientific evidences for prevention of esophageal cancer.Methods A hospital-based case-control study was conducted among 208 esophageal cancer patients and 210 non-digestive tract disease patients recruited at the Fourth Hospital of Hebei Medical University from June 2009 to May 2011.Results There were singificant differences in smoking,alcohol consumption,eating hot and hard food,eating speed,regular eating time,eating mildewed food,taking fruit and fresh vegetables,taking beans and bean product,and taking milk and dairy product between the case and the control groups(P<0.05 for all).The average scores of depression,anger,intrinsic anger,and reason in the cases were 44.30±7.47,24.74±6.71,14.71±2.51,and 42.19±6.50 and higher than those in the controls(40.47±6.87,22.58±5.00,13.82±2.25,and 40.83±3.58)(P<0.01 for all).The average score of social support in the cases was 16.24±3.20,lower than that in the control group(17.53±2.13)(t=4.867,P=0.000).Multinomial logistic regression analyses showed that living in rural area,having a family history of esophageal cancer,having bad family relationship,smoking more than 20 cigarretes a day,eating hard food,eating mildewed food,and with high scores of reason,anger and depression were risk factors of esophageal cancer.Eating beans and its products frequently,drinking tap water,and with a high score of social support were protective factors of esophageal cancer.Having a family history of esophageal cancer,smoking more than 20 cigarrettes a day,eating hard food,eating mildewed food,with high scores of reason and anger were risk factors of esophageal cancer for male residents.Eating beans and its products and with a high score of social support were protective factors of esophageal cancer for male residents.Eating hot and hard food and with a high score of depression were risk factors of esophageal cancer for female residents.Drinking tap water,eating fruits frequently,and with a high social support score were protective factors of esophageal cancer for female residents.Conclusion The incidence of esophageal cancer is strongly associated with environment,diet,smoking,genetic factors,and type-C behavior among the residents in Hebei province and the male and female residents have different risk factors.Specific preventive measures should be taken in different populations.