丽水市胃癌危险因素的病例对照研究
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摘要
目的探讨丽水市胃癌发病的危险因素。方法收集2012年3月~2015年2月在丽水市县级以上医院住院并经病理确诊的胃癌患者210例,作为病例组,采用1∶1配对的病例对照研究的方法,从丽水市各县区健康人群中随机抽取210名作为对照组。通过《居民生活与健康调查表》的问卷,调查胃癌患者和对照人群的相关因素,分析这些因素与胃癌之间的关系。结果通过对两组生活方式和饮食习惯进行单因素方差分析,发现经常饮酒、经常饮绿茶、性格急躁、胃病史、吃饭速度快、经常吃夜宵、经常外出就餐、经常吃腌制食品、经常吃新鲜蔬菜等生活习惯,两组的差异均有统计学意义(P<0.05)。在控制和考虑其他混杂因素后,通过多因素Logistic分析,发现经常吃腌制食品(OR=19.662,95%CI:10.000~38.658,P=0.000)、经常吃夜宵(OR=2.494,95%CI:1.297~4.807,P=0.006)、吃饭速度快(OR=4.329,95%CI:2.273~8.264,P=0.000)、胃病史(OR=2.033,95%CI:1.004~4.119,P=0.049)为丽水市胃癌发病的主要危险因素;经常饮绿茶(OR=0.330,95%CI:0.169~0.647,P=0.001)、经常吃新鲜蔬菜(OR=0.439,95%CI:0.213~0.907,P=0.026)为其保护性因素。结论丽水市胃癌发病与饮食习惯密切相关,改变不良饮食习惯是降低该地区胃癌发病率的重要手段。
[Absrtact] Objective To investigate the risk factors of gastric cancer in Lishui City. Methods Two hundred and ten cases of gastric cancer diagnosed by pathology, that were treated in hospitals above the country level in Lishui City were enrolled in this study as case group from March 2012 to February 2015. The method, 1 ∶1 matched case-control study was used, 2010 healthy people in each country and districts in Lishui City were randomly selected as the control group. By means of "Questionnaire of the Survey of Living and Health of the Population", the correlation factors of gastric cancer patients and control population were investigated and the relationship between these factors and gastric cancer was analyzed. Results Through the one-way ANOVA, it showed that frequent drinking, frequent green tea drinking, impatience, history of stomach disease, eating fast, often eating midnight snacks, often eating out, often eating salted foods, often eating fresh vegetables were found to be statistically different between the case group and the control group(P < 0.05). After controlling and considering other confounding factors, via multiple Logistic analysis method often eating salted food(OR = 19.662, 95%CI:10.000-38.658, P = 0.000), often eating midnight snacks(OR = 2.494,95%CI:1.297-4.807, P = 0.006), eating fast(OR = 4.329, 95%CI:2.273-8.264, P = 0.000), the history of stomach problems(OR = 2.033, 95%CI:1.004-4.119, P = 0.049) were found to be major risk factors of gastric cancer in Lishui; often drinking green tea(OR = 0.330, 95%CI:0.169-0.647, P = 0.001), often eating fresh vegetables(OR = 0.439, 95%CI:0.213-0.907, P = 0.026) were found to be protective factors. Conclusion The incidence of gastric cancer in Lishui City is closely related to eating habits. Changing unhealthy eating habits is an important way to reduce the incidence of gastric cancer in this area.
[Absrtact] Objective To investigate the risk factors of gastric cancer in Lishui City. Methods Two hundred and ten cases of gastric cancer diagnosed by pathology, that were treated in hospitals above the country level in Lishui City were enrolled in this study as case group from March 2012 to February 2015. The method, 1 ∶1 matched case-control study was used, 2010 healthy people in each country and districts in Lishui City were randomly selected as the control group. By means of "Questionnaire of the Survey of Living and Health of the Population", the correlation factors of gastric cancer patients and control population were investigated and the relationship between these factors and gastric cancer was analyzed. Results Through the one-way ANOVA, it showed that frequent drinking, frequent green tea drinking, impatience, history of stomach disease, eating fast, often eating midnight snacks, often eating out, often eating salted foods, often eating fresh vegetables were found to be statistically different between the case group and the control group(P < 0.05). After controlling and considering other confounding factors, via multiple Logistic analysis method often eating salted food(OR = 19.662, 95%CI:10.000-38.658, P = 0.000), often eating midnight snacks(OR = 2.494,95%CI:1.297-4.807, P = 0.006), eating fast(OR = 4.329, 95%CI:2.273-8.264, P = 0.000), the history of stomach problems(OR = 2.033, 95%CI:1.004-4.119, P = 0.049) were found to be major risk factors of gastric cancer in Lishui; often drinking green tea(OR = 0.330, 95%CI:0.169-0.647, P = 0.001), often eating fresh vegetables(OR = 0.439, 95%CI:0.213-0.907, P = 0.026) were found to be protective factors. Conclusion The incidence of gastric cancer in Lishui City is closely related to eating habits. Changing unhealthy eating habits is an important way to reduce the incidence of gastric cancer in this area.
引文
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[14]Ma K,Baloch Z,He TT,et al.Alcohol consumption and gastric cancer risk:a meta-analysis[J].Med Sci Monit,2017,23:238-246.
[15]Tramacere I,Negri E,Pelucchi C,et al.A meta-analysis on alcohol drinking and gastric cancer risk[J].Ann Oncol,2012,23(1):28-36.
[16]戴文玲.青年胃癌75例临床特点分析[J].中国社区医师,2015,31(7):25-26.
[17]Chen HN,Wang Z,Li X,et al.Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia:evidence from a meta-analysis[J].Gastric Cancer,2016,19(1):166-175.
[18]李燕,陆海林,曹婷华,等.青年胃癌危险因素的调查分析[J].中国医药指南,2016,14(27):14-15,17.
[19]Riboli E,Norat T.Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk[J].Am J Clin Nutr,2003,78(3 Suppl):559S-569S.
[20]顾晓平,王银存,智恒奎,等.大丰市食管癌、胃癌发病危险因素及其聚集性病例对照研究[J].中国公共卫生,2016,32(10):1406-1409.
[21]江美花,刘宝英,吴传城,等.仙游县胃癌危险因素的1∶2配对病例对照研究[J].肿瘤防治研究,2016,43(10):898-902.
[2]Didwaniya N,Edmonds RJ,Silberstein PT,et al.Survival outcomes based on race in gastric carcinoma:A SEER database analysis[J].J Clin Oncol,2011,29(4):2696.
[4]梅少林.2009年丽水市死亡慢病监测年度技术分析报告[R].丽水:丽水市疾病预防控制中心,2009.
[5]刘新民,王庆生,马骏,等.天津市区胃癌危险因素的配对病例对照研究[J]中华流行病学杂志,2001(5):48-50.
[6]Wang XQ,Terry PD,Yan H.Review of salt consumption and stomach cancer risk:Epidemiological and biological evidence[J].World J Gastroenterol,2009,15(18):2204-2213.
[7]Shikata K,Kiyohara Y,Kubo M,et al.A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population:the Hisayama study[J].Int J Cancer,2006,119(1):196-201.
[8]刘世炜,蔡玥,曾新颖,等.2013年中国居民高盐饮食对死亡和期望寿命的影响[J].中华流行病学杂志,2017,38(8):1022-1027.
[9]周晓彬,张健,张超英.中国人群生活习惯与胃癌发病关系的Meta分析[J].中国临床康复,2006(48):10-13.
[10]Wang R,Zhang MG,Chen XZ,et al.Risk population of Helicobacter pylori infection among Han and Tibetan ethnicities in western China:a cross-sectional,longitudinal epidemiological study[J].Lancet,2016,388:S17.
[11]任波.汉族与藏族胃癌发病率及危险因素分析[J].解放军预防医学杂志,2017,35(5):465-466,470.
[12]Banerjee R,Ramji C,Mansard MJ,et al.High Resolution Natrow Band Imaging(NBI)Can Identify Normal Gastric Mucosa and H.Pylori(HP)Associated Gastritis[J].Gastrointest Endosc,2007,65(5):AB178.
[13]Ladeiras-Lopes R,Pereira AK,Nogueira A,et al.Smoking and gastric cancer:systematic review and meta-analysis of cohort studies[J].Cancer Causes Control,2008,19(7):689-701.
[14]Ma K,Baloch Z,He TT,et al.Alcohol consumption and gastric cancer risk:a meta-analysis[J].Med Sci Monit,2017,23:238-246.
[15]Tramacere I,Negri E,Pelucchi C,et al.A meta-analysis on alcohol drinking and gastric cancer risk[J].Ann Oncol,2012,23(1):28-36.
[16]戴文玲.青年胃癌75例临床特点分析[J].中国社区医师,2015,31(7):25-26.
[17]Chen HN,Wang Z,Li X,et al.Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia:evidence from a meta-analysis[J].Gastric Cancer,2016,19(1):166-175.
[18]李燕,陆海林,曹婷华,等.青年胃癌危险因素的调查分析[J].中国医药指南,2016,14(27):14-15,17.
[19]Riboli E,Norat T.Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk[J].Am J Clin Nutr,2003,78(3 Suppl):559S-569S.
[20]顾晓平,王银存,智恒奎,等.大丰市食管癌、胃癌发病危险因素及其聚集性病例对照研究[J].中国公共卫生,2016,32(10):1406-1409.
[21]江美花,刘宝英,吴传城,等.仙游县胃癌危险因素的1∶2配对病例对照研究[J].肿瘤防治研究,2016,43(10):898-902.