原发性肝癌相关因素1：2病例对照研究
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摘要
目的:通过对大连市原发性肝癌相关因素的调查分析,探讨影响原发性肝癌发病的相关危险因素,为原发性肝癌的防治提供依据。
方法:采用1:2配比的病例对照研究,所有研究对象均来自2007年3月~2008年3月间,在大连市内多家综合性医院住院、并且在大连市区居住10年及以上的病人。病例选择新入院的被确诊为原发性肝癌的患者110例,同时在同期住院的非肿瘤、非消化道疾病的患者中选择对照220名,匹配条件为:同性别、年龄±3岁。使用统一设计的调查表,由经过培训的调查员对研究对象本人进行面对面的调查。调查表的内容主要包括:一般情况、职业暴露史、生活居住环境、生活行为、疾病史、家族史、饮食习惯及心理因素等。所获资料采用Excel2003建立数据库,并采用SPSS13.0和SAS8.2统计软件进行分析,根据资料的类型采用χ~2检验、秩和检验和单因素条件Logistic回归分析,并采用多因素条件Logistic回归模型进行多因素分析。
结果:经单因素分析结果显示:1.两组在文化程度、家庭收入及生活费的支出、职业构成等方面,没有统计学差异,但在工作中有毒有害物质接触史上,有统计学差异(χ~2=6.42,P=0.01)。2.通过对生活居住环境的回顾调查及分析发现,十年前居住地周围有无排放污染的工厂、近10年家里有无大型的装修史、装修后入住的时间方面与肝癌的发生有关联。3.通过对行为生活方式的调查发现,吸烟、酗酒、熬夜可能是肝癌的危险因素(OR=1.76,95%CI=1.02~3.01;OR=1.98,95%CI=1.14~3.46;OR=2.32,95%CI=1.42~3.77),经常进行体育锻炼则能降低原发性肝癌发生的危险(OR=0.36,95%CI=0.21~0.62)。4.通过对疾病史、癌症家族史的调查,结果显示,两组在糖尿病史、癌症家族史上具有统计学差异(χ~2=20.53,P=0.00;χ~2=24.66,P=0.00)。5.在饮食方面,经常摄入近海贝类、腌制食品、煎、炸、烤制食品和食用变质的花生可能是原发性肝癌的危险因素,而多吃生蒜可能是原发性肝癌的保护因素(OR=0.39,95%CI=0.18~0.57)。6.对社会心理因素的调查发现,经历过负性事件、在生活和工作中常感到有压力、长时间处于精神压抑的人,患原发性肝癌的危险性更大。7.经过多因素条件Logistic回归分析结果显示:工作中接触有毒有害物质、经常熬夜、有糖尿病史、有癌症家族史、在生活或工作中常感到压力、有过长期的精神压抑状态、经常摄入近海贝类、煎、炸、烤制食品和生蒜是影响原发性肝癌发病的因素。
结论:大连市原发性肝癌的发病是多因素综合作用的结果;其中工作中接触有毒有害物质、经常熬夜、糖尿病史、癌症家族史、经常摄入近海贝类、煎、炸、烤制食品、生活或工作中常感到压力、有过长期的精神压抑状态等因素是原发性肝癌的危险因素;而多食生蒜对肝癌的发生具有保护作用。
Objective: Through the investigation and the statistical analysis of Dalian Primary Hepatic Carcinoma patients to explore the related risk factors that affect the occurrence of Primary Hepatic Carcinoma, provide reference for the prevention of Primary Hepatic Carcinoma.
Methods: A 1:2 matched case-control study was carried out in Dalian including 110 cases and 220 controls in synthesize hospital of Dalian from March, 2007 to March, 2008. The cases were patients of Primary Hepatic Carcinoma who were made a definite diagnosis and new hospitalization, and lived in Dalian city for 10 years and above. According to the principle of 1:2 matched case-control study, the control were non- tumor and no disease of digestive in the same period in the same hospital. The match conditions are same gender, younger or older 3 years old, and live in the city of Dalian for 10 years and above. The main contents of questionnaire included that general state of health, occupation, inhabited environment, life behavior, the history of disease, the family history of cancer, eating habit, and psychological factor et.al. Data were input to the computer by the software of EXCEL 2003 analyzed with Chi-square test, Nonparametric test and the conditional Logistic regression by the software of SPSS 13.0 and SAS 8.2.
Results:1.There ware no statistics difference between the two group in the aspect that educational level, family income and living expenses, occupation and so on, but there ware difference in the facet that touching poisonous or noxious substance (χ~2=6.42, P=0.01). 2.Through reviewing the inhabited environment, we found that there were statistics difference between the two group in the aspect of weather the pollution factory exist near the inhabited address, weather decorating the house during the near ten years. 3. Through investigating the behavior, we found that there were statistics difference between the two groups in the aspect of smoking, drinking, exercising, staying up late or all night (OR=1.76,95%CI=1.02~ 3.01;OR=1.98,95%CI=1.14~3.46;OR=2.32,95%CI=4.12~3.77), and there were no statistics difference in the aspect of passive smoking, drinking tee. 4. There were statistics difference between the two groups in the aspect of the history of diabetes (χ~2=20.53, P=0.00), and the family history of cancer (χ~2=24.66,P=0.00). 5. In the dietary factor, eating frying food, seashell or garlic were relative with Primary Hepatic Carcinoma. 6. Through investigating the social psychic factor, we found that there were statistics difference between the two group in the aspect of experiencing the negative events, feeling pressure frequently, having the experience of pressure during a long time. According the multiple conditional logistic regression, there were close relationship between Primary Hepatic Carcinoma and the factors include that touching poisonous or noxious substance, stay up late or all night frequently, the history of diabetes, the family history of cancer, feeling pressure frequently, having the experience of pressure during a long time, eating garlic,seashell or frying food. Except eating garlic is the protective factor, the others were the risk factors of Primary Hepatic Carcinoma.
Conclusion: There were close relationship between Primary Hepatic Carcinoma and the factors include that touching poisonous or noxious substance, stay up late or all night frequently, the history of diabetes, the family history of cancer, feeling pressure frequently, having the experience of pressure during a long time, eating garlic,seashell or frying food. Except eating garlic is the protective factor, the others were the risk factors of Primary Hepatic Carcinoma.
方法:采用1:2配比的病例对照研究,所有研究对象均来自2007年3月~2008年3月间,在大连市内多家综合性医院住院、并且在大连市区居住10年及以上的病人。病例选择新入院的被确诊为原发性肝癌的患者110例,同时在同期住院的非肿瘤、非消化道疾病的患者中选择对照220名,匹配条件为:同性别、年龄±3岁。使用统一设计的调查表,由经过培训的调查员对研究对象本人进行面对面的调查。调查表的内容主要包括:一般情况、职业暴露史、生活居住环境、生活行为、疾病史、家族史、饮食习惯及心理因素等。所获资料采用Excel2003建立数据库,并采用SPSS13.0和SAS8.2统计软件进行分析,根据资料的类型采用χ~2检验、秩和检验和单因素条件Logistic回归分析,并采用多因素条件Logistic回归模型进行多因素分析。
结果:经单因素分析结果显示:1.两组在文化程度、家庭收入及生活费的支出、职业构成等方面,没有统计学差异,但在工作中有毒有害物质接触史上,有统计学差异(χ~2=6.42,P=0.01)。2.通过对生活居住环境的回顾调查及分析发现,十年前居住地周围有无排放污染的工厂、近10年家里有无大型的装修史、装修后入住的时间方面与肝癌的发生有关联。3.通过对行为生活方式的调查发现,吸烟、酗酒、熬夜可能是肝癌的危险因素(OR=1.76,95%CI=1.02~3.01;OR=1.98,95%CI=1.14~3.46;OR=2.32,95%CI=1.42~3.77),经常进行体育锻炼则能降低原发性肝癌发生的危险(OR=0.36,95%CI=0.21~0.62)。4.通过对疾病史、癌症家族史的调查,结果显示,两组在糖尿病史、癌症家族史上具有统计学差异(χ~2=20.53,P=0.00;χ~2=24.66,P=0.00)。5.在饮食方面,经常摄入近海贝类、腌制食品、煎、炸、烤制食品和食用变质的花生可能是原发性肝癌的危险因素,而多吃生蒜可能是原发性肝癌的保护因素(OR=0.39,95%CI=0.18~0.57)。6.对社会心理因素的调查发现,经历过负性事件、在生活和工作中常感到有压力、长时间处于精神压抑的人,患原发性肝癌的危险性更大。7.经过多因素条件Logistic回归分析结果显示:工作中接触有毒有害物质、经常熬夜、有糖尿病史、有癌症家族史、在生活或工作中常感到压力、有过长期的精神压抑状态、经常摄入近海贝类、煎、炸、烤制食品和生蒜是影响原发性肝癌发病的因素。
结论:大连市原发性肝癌的发病是多因素综合作用的结果;其中工作中接触有毒有害物质、经常熬夜、糖尿病史、癌症家族史、经常摄入近海贝类、煎、炸、烤制食品、生活或工作中常感到压力、有过长期的精神压抑状态等因素是原发性肝癌的危险因素;而多食生蒜对肝癌的发生具有保护作用。
Objective: Through the investigation and the statistical analysis of Dalian Primary Hepatic Carcinoma patients to explore the related risk factors that affect the occurrence of Primary Hepatic Carcinoma, provide reference for the prevention of Primary Hepatic Carcinoma.
Methods: A 1:2 matched case-control study was carried out in Dalian including 110 cases and 220 controls in synthesize hospital of Dalian from March, 2007 to March, 2008. The cases were patients of Primary Hepatic Carcinoma who were made a definite diagnosis and new hospitalization, and lived in Dalian city for 10 years and above. According to the principle of 1:2 matched case-control study, the control were non- tumor and no disease of digestive in the same period in the same hospital. The match conditions are same gender, younger or older 3 years old, and live in the city of Dalian for 10 years and above. The main contents of questionnaire included that general state of health, occupation, inhabited environment, life behavior, the history of disease, the family history of cancer, eating habit, and psychological factor et.al. Data were input to the computer by the software of EXCEL 2003 analyzed with Chi-square test, Nonparametric test and the conditional Logistic regression by the software of SPSS 13.0 and SAS 8.2.
Results:1.There ware no statistics difference between the two group in the aspect that educational level, family income and living expenses, occupation and so on, but there ware difference in the facet that touching poisonous or noxious substance (χ~2=6.42, P=0.01). 2.Through reviewing the inhabited environment, we found that there were statistics difference between the two group in the aspect of weather the pollution factory exist near the inhabited address, weather decorating the house during the near ten years. 3. Through investigating the behavior, we found that there were statistics difference between the two groups in the aspect of smoking, drinking, exercising, staying up late or all night (OR=1.76,95%CI=1.02~ 3.01;OR=1.98,95%CI=1.14~3.46;OR=2.32,95%CI=4.12~3.77), and there were no statistics difference in the aspect of passive smoking, drinking tee. 4. There were statistics difference between the two groups in the aspect of the history of diabetes (χ~2=20.53, P=0.00), and the family history of cancer (χ~2=24.66,P=0.00). 5. In the dietary factor, eating frying food, seashell or garlic were relative with Primary Hepatic Carcinoma. 6. Through investigating the social psychic factor, we found that there were statistics difference between the two group in the aspect of experiencing the negative events, feeling pressure frequently, having the experience of pressure during a long time. According the multiple conditional logistic regression, there were close relationship between Primary Hepatic Carcinoma and the factors include that touching poisonous or noxious substance, stay up late or all night frequently, the history of diabetes, the family history of cancer, feeling pressure frequently, having the experience of pressure during a long time, eating garlic,seashell or frying food. Except eating garlic is the protective factor, the others were the risk factors of Primary Hepatic Carcinoma.
Conclusion: There were close relationship between Primary Hepatic Carcinoma and the factors include that touching poisonous or noxious substance, stay up late or all night frequently, the history of diabetes, the family history of cancer, feeling pressure frequently, having the experience of pressure during a long time, eating garlic,seashell or frying food. Except eating garlic is the protective factor, the others were the risk factors of Primary Hepatic Carcinoma.
引文
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