遗传和环境危险因素与淮安食管癌发病风险的关系

背景与目的： 评价遗传与环境危险因素在江苏省淮安食管癌发病风险中的意义。 材料与方法: 采用配对病例_对照研究对97例淮安汉族食管癌新发病例及其匹配对照进行了食管癌遗传与环境危险因素的调查，条件Logistic逐步回归分析遗传与环境因素与食管癌发病风险的关系。 结果: 淮安食管癌的主要危险因素中消化道肿瘤家族史与食管癌发病关系最为密切，OR可达4.203 ；其次是住地周围环境污染、三餐不定时和饮水类型，OR分别为2.202、1.988和2.024；经常食用蛋类食品和饮茶习惯与食管癌发病风险降低有关，是食管癌的保护因素，其OR分别为0.633和0.669。各危险因素的调整人群归因危险度分别为：住地周围环境污染12.9％、三餐不定时34.4％、少食蛋类食品25.0％、不饮茶42.7％、饮用河水、沟塘水和井水21.4％、消化道肿瘤家族史30.6％，这6个因素的综合人群归因危险度为86.6％。 结论: 遗传易感特征在淮安地区食管癌的发生中占有重要地位，对当地食管癌的防治措施应充分考虑遗传因素的影响。

The Genetic and EnvironmentalRisk Factors for EsophagealCancer in Huaian

BACKGROUND AND AIM: To explore the significance of genetic and environmental risk factors for ethnic esophageal cancer in Huaian.MATERIALS AND METHODS: A community-based pair-matching case-control study was performed.97 patients with newly diagnosed,untreated ESCC and 97 healthy controls matched in age,sex,origin and residence were surveyed by questionnaire in the study.Logistic regression analysis was used to evaluate the risk of genetic and environmental factors for esophageal cancer.RESULTS: The conditional logistic regression analysis showed that the increased risk for esophageal cancer was significantly associated with a family history of gastrointestinal tumor(OR=4.203),environmental pollution around the residential area(OR=2.202),irregular meals(OR=1.988),and history of drinking non-tap water(OR=2.024).The protective factors of esophageal cancer included intake of eggs(OR=0.633) and tea-consumption(OR=0.669).Population attributable risk(PAR) of each factor was 12.9% with environmental pollution around the residential area,34.4% with irregular meals,25.0% with lack of intake of eggs,42.7% with lack of tea-consumption,21.4% with history of drinking non-tap water,and 30.6% with family history of gastrointestinal tumor.The combined PAR of the six factors was 86.6%.CONCLUSION: Genetic susceptibility factors play an important role in the high incidence of esophageal cancer in Huaian county.The influence of genetic factors should be considered in the surveillance and comprehensive prevention of esophageal cancer in Huaian.