男性食管癌影响因素的病例对照研究

目的 探讨食管癌高发区肥城市男性食管癌的影响因素。方法 在肥城市一食管癌高发乡镇40～69岁队列人群中，采用染色内镜和活检病理诊断方法确诊男性食管癌64例，另选取肥城市人民医院男性食管癌住院患者116例，将其作为病例组；选取内镜检查正常者220例作为对照组。分析食管癌家族史、吸烟、饮酒等与食管癌的关联，以OR及95%CI作为评价关联强度的指标。结果 将年龄和文化水平作为调整因素，未发现食管癌家族史与食管癌有统计学关联；以吸烟指数=0为比较的基线水平（OR=1.0），吸烟指数<550和≥550的OR分别为1.552(95%CI 为0.844～2.851)、2.273(95%CI 为1.248～4.142)；以饮酒指数=0为比较的基线水平（OR=1.0），饮酒指数<130和≥130的OR分别为2.887 (95%CI 为1.468～5.679)、3.281 (95%CI 为1.780～6.045)；以不吸烟+不饮酒为比较的基线水平（OR=1.0），吸烟+饮酒的OR为2.907 (95%CI 为1.372～6.162)。结论 吸烟、饮酒是男性食管癌的危险因素，其影响具有一定的剂量-效应关系，二者共同暴露存在一定的协同作用。在食管癌高发区，应提倡戒烟戒酒，以减少和预防食管癌的发生。

A case-control study on influencing factors of esophageal squamous cell cancer in males of Feicheng City

Objective    To investigate the influencing factors of esophageal squamous cell cancer（ESCC） in males of Feicheng City, a high ESCC incidence area of Shandong Province, China. Methods    In a high incidence community of ESCC, a cohort of residents aged from 40 to 69 were examined for esophageal lesions. The case group included 64 male cases of ESCC diagnosed by staining endoscope and pathogenic examination and 116 male inpatients of Feicheng People′s Hospital，and 220 males with normal esophageal mucosa determined by gastric endoscope served as the control group. The associations of family history of esophageal cancer, smoking and drinking with esophageal cancer were analyzed, and OR and 95%CI were used as the association indicators. Results    Age and education level were regarded as adjusting factors. No significant association was found between family history of esophageal cancer and ESCC. When smoking index=0 was used as the base line（OR=1.0）, the OR was 1.552 (95%CI:0.844-2.851) and 2.273 (95%CI: 1.2484.142)  for smoking index <550 and ≥550 respectively; when drinking index=0 was used as the base line（OR=1.0）, the OR was 2.887  (95%CI: 1.468 5.679) and 3.281 (95%CI: 1.780 6.045) for drinking index <130 and ≥130 respectively; when no-smoking and no-drinking was used as the base line（OR=1.0）, the OR was 2.907 (95%CI: 1.372 6.162) for both smoking and drinking.  Conclusion    Smoking and drinking are risk factors of ESCC for males with dose-effect relationships, and there is synthetic effect between smoking and drinking on esophageal cancer. Abstinence from smoking and drinking has important preventive effect against esophageal cancer in high incidence areas of ESCC.