摘要
[目的]探讨影响中国非食管癌高发区食管鳞癌发病的危险因素。[方法]采用前瞻性研究设计,对江苏省、山东省及河南省3个非食管癌高发区的32 446名40~69岁研究对象进行前瞻性随访,采用Cox比例风险回归分析探索影响食管鳞癌发生的危险因素。[结果]本研究基线共纳入32 446名研究对象,男女性别比例为1∶1.34,年龄(53.22±8.10)岁,正在吸烟率和正在饮酒率分别为21.91%和18.23%。在5.01年随访期间,共出现247例食管鳞癌新发病例,食管鳞癌发病密度为150.19/10万人年。多因素Cox回归分析结果显示,高龄(50岁年龄组HR=4.78,95%CI:2.84~8.04,60岁年龄组HR=10.04,95%CI:6.03~16.70),男性(HR=1.43,95%CI:1.05~1.94),具有上消化道癌恶性肿瘤家族史者(HR=1.95,95%CI:1.48~2.58),有食管警示症状者(HR=1.74,95%CI:1.30~2.34),正在吸烟者(HR=1.49,95%CI:1.09~2.03),BMI<22kg/m2(HR=1.31,95%CI:1.01~1.71),低水果摄入者(HR=1.33,95%CI:1.01~1.76),高腌制食物摄入者(HR=1.45,95%CI:1.12~1.88),具有更高的食管鳞癌发病风险。[结论]高龄、男性、上消化道癌恶性肿瘤家族史、食管警示症状、吸烟、高腌制食品摄入是食管鳞癌发生的危险因素,增加新鲜水果摄入是食管鳞癌发生的保护因素。
[Purpose]To explore the effects of the major risk factors of esophageal squamous cell carcinoma(ESCC)in three non-high prevalence regions of esophageal cancer in China.[Methods]We performed a population-based cohort of 32 446 individuals,aged 40 to 69 years from three regions of non-high prevalence of esophageal cancer in three provinces of Jiangsu,Shandong and Henan of China.Cox proportional hazards regression analysis was conducted to estimate the potential factors with risk of ESCC.[Results]A total of 32 446 participants were recruited in this study at baseline,with male/female ratio of 1∶1.34,and the average age of(53.22±8.10)years.The prevalence of current cigarette smoking and current alcohol drinking was 21.91%and 18.23%,respectively.During an average 5.01 years of follow-up,247 participants developed ESCC and the incidence density of ESCC was 150.19/100 000 person-years.Multivariate Cox regression analysis showed that ages(for 50 s,HR=4.78,95%CI:2.84~8.04;for 60 s,HR=10.04,95%CI:6.03~16.70),males(HR=1.43,95%CI:1.05~1.94),those who had family history of upper gastrointestinal cancer(HR=1.95,95%CI:1.48~2.58)and had clinical symptoms of esophageal warning symptoms(HR=1.74,95%CI:1.30~2.34)were more prone to ESCC.In addition,current smoker(HR=1.49,95%CI:1.09~2.03),those who had BMI<22 kg/m2(HR=1.31,95%CI:1.01~1.71),lower intake of fresh fruit(HR=1.33,95%CI:1.01~1.76),and higher intake of pickled food(HR=1.45,95%CI:1.12~1.88)were more likely to develop ESCC.[Conclusion]Ages,males,family history of upper gastrointestinal cancer,esophageal warning symptoms,smoking,less BMI,higher intake of pickled food are the risk factors of ESCC,while,higher intake of fresh fruit is the protective factor of ESCC.
作者
李贺
曾红梅
邹小农
郑荣寿
周金意
罗鹏飞
王家林
马恒敏
冯石献
范雷
陈万青
LI He;ZENG Hong-mei;ZOU Xiao-nong;ZHENG Rong-shou;ZHOU Jin-yi;LUOPeng-fei;WANG Jia-lin;MA Heng-min;FENG Shi-xian;FAN Lei;Chen Wan-qing(National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing100021,China;JiangsuProvincial Center for Disease Control and Prevention,Nanjing210009,China;Shandong CancerHospital Affiliated to Shandong University,Jinan250117,China;Henan Provincial Center forDisease Control and Prevention,Zhengzhou450046,China)
出处
《中国肿瘤》
CAS
CSCD
北大核心
2019年第10期726-730,共5页
China Cancer
基金
科技部国家重点研发计划(2018YFC1313100)
中国医学科学院医学与健康科技创新工程(2016-I2M-2-004)
关键词
食管鳞癌
发病
危险因素
前瞻性研究
esophageal squamous cell carcinoma
incidence
risk factors
prospective study
