河南省林州市食管鳞癌及癌前病变的影响因素研究

[目的]探讨河南省林州市食管鳞癌及癌前病变的影响因素。[方法]按照性别、年龄进行1∶1∶1匹配的原则,选取2019年5~10月在林州市食管癌医院就诊的新发食管鳞癌患者、新发中重度食管鳞状上皮异型增生患者和正常对照匹配成33个区组作为研究对象。对入组的研究对象进行问卷调查,收集其人口学、生活方式等信息,采用多元有序Logistic回归对食管鳞癌及癌前病变的影响因素进行统计学分析。[结果]单因素分析结果显示,教育程度,饮用水来源,吸烟,饮酒,饮茶,食用西兰花、大蒜、酸菜、烟熏制品,劳动强度,消化道疾病史,食管癌家族史与食管鳞癌及癌前病变发生有关(P<0.05)。多元有序Logistic回归结果显示,教育程度(小学:OR=2.128,95%CI:1.116~3.187;中学及以上:OR=1.960,95%CI:1.080~2.759),饮用浅层地下水、井水(OR=3.595,95%CI:1.051~7.130),现在吸烟(OR=2.027,95%CI:1.435~5.193),经常食用酸菜(OR=2.520,95%CI:1.030~4.498),经常食用烟熏制品(OR=1.312,95%CI:1.089~1.739),有消化道疾病史(OR=2.277,95%CI:1.038~2.828)是食管鳞癌及癌前病变的独立危险因素,而经常食用西兰花(OR=0.520,95%CI:0.031~0.855)是独立保护因素。[结论]在林州市,生活方式、饮食习惯和消化道病史均可影响食管鳞癌及癌前病变的发生,有其地域特点,应针对相关影响因素采取相应的预防措施。

Risk Factors of Esophageal Squamous Cell Carcinoma and Precancerous Lesions in Linzhou,Henan

[Purpose] To investigate the risk factors of esophageal squamous cell carcinoma and its precancerous lesions among Linzhou residents. [Methods] From May to October 2019,33 esophageal squamous cell carcinoma cases,33 moderate or severe esophageal squamous dysplasia cases and 33 healthy controls were selected as the subjects of study according to the principle of with gender and age matched. Questionnaire survey was carried out to collect the demographic and lifestyle information of the subjects. The multivariate ordinal Logistic regression analysis was used to analyze the independent risk factors of esophageal squamous cell carcinoma and its precancerous lesions. [Results] The univariate analysis showed that esophageal squamous cell carcinoma and its precancerous lesions were significantly associated with education level,source of drinking water,smoking,alcohol and tea drinking,consumption of broccoli,garlic,pickled vegetables and smoked products,labor intensity,history of digestive tract diseases and family history of esophageal cancer(P<0.05). The multivariate analysis showed that education level(primary education:OR=2.128,95%CI:1.116~3.187;middle education and above:OR=1.960,95%CI:1.080~2.759),drinking shallow groundwater and well water(OR=3.595,95%CI:1.051~7.130),current smoking(OR=2.027,95% CI:1.435 ~5.193),frequent consumption of pickled vegetables(OR =2.520,95% CI:1.030~4.498),frequent consumption of smoked products(OR=1.312,95%CI:1.089~1.739),history of digestive tract diseases(OR=2.277,95%CI:1.038~2.828) were the independent risk factors of esophageal squamous cell carcinoma and its precancerous lesions,while frequent consumption of broccoli(OR =0.520,95% CI:0.031 ~0.855) was the independent protective factor. [Conclusion]Lifestyle,diet and history of digestive tract diseases can affect the occurrence of esophageal squamous cell carcinoma and its precancerous lesions in Linzhou. Due to its geographical characteristics,corresponding preventive measures should be taken according to relevant risk factors.