恶性肿瘤家族史与肺癌发生危险的系统评价

目的探讨恶性肿瘤家族史与肺癌发生的关系。方法通过计算机检索PubMed、CENTRAL、中国生物医学文献数据库系统(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP),收集国内外在1988—2009年间公开发表的恶性肿瘤家族史与肺癌关系的病例-对照研究。采用系统评价方法对各研究结果进行分析,计算其合并优势比(OR)和95%可信区间(CI)。结果纳入合并分析的文章共17篇(10490例病例),结果表明,恶性肿瘤家族史与一级亲属肺癌的发生有关(OR=1.58,95%CI:1.31～1.91,P0.0001)。分层分析表明,一级亲属患恶性肿瘤与非吸烟者肺癌的发生有关(OR=1.46,95%CI:1.08～1.97,P=0.01);一级亲属患肺癌与肺癌的发生有关(OR=1.71,95%CI:1.49～1.95,P0.0001);一级亲属中父亲、母亲及兄弟姐妹(包括同父异母和同母异父者)患恶性肿瘤与肺癌的发生有关OR值分别为1.43(95%CI:1.10～1.84,P=0.007)、1.36(95%CI:0.99～1.87,P=0.06)和1.51(95%CI:1.35～1.69,P0.0001)]。结论恶性肿瘤家族史明显增加一级亲属患肺癌的风险。

Systematic Review of the Relationship between Family History of Malignant Tumor and Lung Cancer Risk

Objective To discuss the relationship between family history of malignant tumor and lung cancer risk. Methods By searching PubMed, CENTRAL （the Coehrane central register of controlled trials）,CBM,CNKI,VIP and et al.We collected both domestic and overseas published case-control studies of family history of malignant tumor and lung cancer risk between 1988 and 2009.The results of the included studies was analysised by using systematic review method.The combined odds ratio （OR） and its 95% confidence interval （CI） were calculated as well. Results 17 documents （ 10 490 cases）were included into the combined analysis, which indicated that there was obvious significance between family history of malignant tumor and lung cancer risk （OR= 1.58,95%CI： 1.31 -1.91, P〈0.00001）.In the sub-study,lung cancer risk in non-smoking subjects has a relationship with family history of malignant tumor in first degree relatives （OR= 1.46,95%CI： 1.08-1.97, P=0.01）.Lung cancer risk has a relationship with family history of lung cancer in first degree relatives（OR=1.71, 95%CI： 1.49-1.95, P〈0.00001）.Lung cancer risk has a relationship with with family history of malignant tumor in first degree relatives by father,mother and siblings （0R=1.43,95%CI：1.10-1.84, P=0.007; OR= 1.36,95%CI： 0.99-1.87, P=0.06; OR = 1.51,95%CI： 1.35- 1.69, P〈0.000 01）. Conclusion Increased lung cancer risk was observed in association with family history of malignant tumor in first degree relatives.