肺癌危险度与非肿瘤肺部疾病关系研究

目的 发现非肿瘤肺部疾病对肺癌危险度的直接影响。方法 在甘肃省进行的病例-对照流行病学研究，涉及到在1994年1月至1998年4月期间发生的886名肺癌病例（男性656名，女性230名）。病例调查表中收集了多种诱发肺癌危险因素的资料。其中包括非肿瘤肺部疾病史（肺结核，慢性气管炎/肺气肿，哮喘，肺炎），初次发病诊断年龄和年份，接受治疗和法院情况等。通过分析这些资料，找出非肿瘤肺部疾病史与肺癌危险度的关系。结果 在对主动吸烟和社会经济因素进行调整后，发现肺癌危险度的增加与肺结核及慢性气管炎/肺气肿直接有关，其比值比（OR）和95%置信区间（CI）分别为OR=2.1(95%CI:1.4-3.1)与OR=1.4(95%CI:1.1-1.8)，哮喘与肺炎也使肺癌OR值增加，其值分别为OR=1.4，（95%CI：0.9-2.1)。与OR=1.5(95%CI:1.0-2.3)。当只对有病理诊断的病例和由本人回答的资料进行分析时，肺结核与慢性气管炎/肺气肿导致肺癌危险度的增加也是显的。结论 本研究提供了新的证据。证明以往的肺结核与慢性气管炎/肺气肿使致肺癌危险度显增加。哮喘和肺炎与肺癌的关系虽然也是正相关。但还没达到统计显水平。

Previous Pulmonary Diseases and Risk of Lung Cancer

Objective To identify prior lung diseases may be an independent risk factor for lung cancer.Methods A population- based case- control study in Gansu Province, China identified 886 lung cancer cases (656 male, 230 female) diagnosed between January, 1994 and April, 1998.A standardized interview collected information on a variety of potential risk factors including a history of physician - diagnosed nonmalignant lung diseases (pulmonary tuberculosis, chronic bronchitis/emphysema, asthma, pneumonia) , age and year in which each condition was first diagnosed, and any therapy or hospitalization received.Results Pulmonary tuberculosis (odds ratio [OR] =2.1, 95% CI 1.4-3.1) and chronic bronchitis/emphysema ( OR = 1.4, 95% CI 1.1 - 1.8) were associated with increased risk of lung cancer after adjustment for active smoking and socioeconomic status. ORs for asthma ( OR = 1.4, 95% C/0.9-2.1) and pneumonia (OR =1.5, 95% C/1.0-2.3) were also elevated. The risk of lung cancer remained significant for pulmonary tuberculosis and chronic bronchitis/emphysema when analysis was limited to the pathologically confirmed cases and self- responders. Conclusion This study provides evidence that previous pulmonary tuberculosis and chronic bronchitis/emphysema are related to lung cancer.The results for asthma and pneumonia, while suggestive of a positive association, did not reach the level of statistical significance.