肺癌危险因素及交互作用研究

目的探讨肺癌的影响因素及其交互作用。方法采用病例对照研究设计,收集781例肺癌病例,并按性别、年龄(±3岁)进行1:1匹配,通过调查问卷获取生活饮食习惯等信息。构建决策树及非条件Logistic回归模型,计算OR值及其95%CI,分析影响因素间的交互作用。结果肺癌的危险因素有吸烟(轻度吸烟OR=1.67,重度吸烟OR=7.27)、被动吸烟(轻度被动吸烟OR=2.63,重度被动吸烟OR=6.25)、居住地污染(吸烟者OR=2.26,不吸烟者OR=1.72)、肺癌家族史(吸烟者OR=15.94);保护因素有常吃水果(吸烟者OR=0.69,不吸烟者OR=0.44)、锻炼(吸烟者OR=0.50)、饮茶(不吸烟者OR=0.57)。吸烟与居住地污染、肺癌家族史存在交互作用,重度吸烟与不锻炼存在交互作用。结论吸烟、被动吸烟、居住地污染、肺癌家族史可增加肺癌风险,常吃水果、锻炼、饮茶有助于预防肺癌。肺癌影响因素间的协同作用应予重视。

Study on influencing factors and their interactions for lung cancer

Objective To explore the influencing factors of lung cancer and their interaction effects.Methods Using case-control study,781 cases and 781 controls matched for age（±3 years） and gender were recruited,and surveyed by epidemiological questionnaire.Decision trees and unconditional Logistic regression models were constructed,OR and 95% CI and additive interaction effect were computed.Results Risk factors of lung cancer included：smoking（light smokers OR=1.67,heavy smokers OR=7.27）;passive smoking（light passive smokers OR=2.63,heavy passive smokers OR=6.25）;industrial pollution near residence（smokers OR=2.26,non-smokers OR=1.72）;family history of lung cancer（smokers OR=15.94）.Protective factors of lung cancer included：fruit intake constantly（smokers OR=0.69,non-smokers OR=0.44）;exercise（smokers OR=0.50）;tea consumption（non-smokers OR=0.57）.Smoking had interactive effect on industrial pollution nearby residence and family history of lung cancer,and heavy smoking interactive effect on non-exercise.Conclusions Smoking,passive smoking,industrial pollution near residence,family history of lung cancer may increase lung cancer risk,while fruit intake constantly,exercise,tea consumption likely help prevent lung cancer.The synergistic effect among impact factors for lung cancer should be concerned.