某地区胃黏膜肠上皮化生危险因素分析
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摘要
目的分析宁夏地区胃黏膜肠上皮化生(IM)发生的危险因素,为胃癌的防治提供依据。方法选取2012年1月-2014年1月于宁夏医科大学总医院消化内镜中心行电子胃镜检查和胃镜活检病理诊断为IM患者112例为病例组,同期健康体检者182例为对照组,并行电话问卷调查相关暴露因素,采用病例对照研究方法,应用非条件Logistic回归模型进行单因素与多因素分析。结果单因素分析结果显示两组年龄≥55岁、吸烟、饮酒、喜饮浓茶、饮食不规律、重盐饮食、喜食辛辣食物、喜食油炸食物、常吃腌制咸菜、常吃水果、常吃蔬菜、常吃枸杞制品、胃癌家族史、幽门螺旋杆菌感染史具有统计学意义(P<0.05);对单因素分析有统计学意义的因素进一步进行多因素非条件Logistic回归分析,结果显示7个因素与IM的联系差异有统计学意义(P<0.05),其中年龄≥55岁(OR=2.885)、喜食油炸食物(OR=2.355)、常吃腌制咸菜(OR=1.883)、幽门螺旋杆菌感染史(OR=2.693)和胃癌家族史(OR=3.309)是IM发生的独立危险因素,而吃水果≥3次/周(OR=0.523)和枸杞制品≥3次/周(OR=0.529)是其保护性因素。结论年龄、不当饮食、胃癌家族史、幽门螺旋杆菌感染史是宁夏地区IM主要的危险因素,应常吃枸杞制品及水果,有助于减少IM的发生。
Objective To analyze the risk factors of gastric intestinal metaplasia in Ningxia in order to contribute to the prevention and treatment of gastric cancer.Methods Patients of the case group( 112 patients) who were admitted into our hosptial between January 2012 and January 2014 due to gastric intestinal metaplasia were confirmed by endoscopy and pathology,while another 182 healthy people were selected as the control group.Telephone questionnaires were adopted to obtain related exposure factors,whereas single-factor and multi-factor analyses were performed by non-conditional logistic regression. Results According to the results of Chi-square test,age of 55 or above,smoking,alcoholic drinking,tea drinking,irregluar diet,high-salt taste,spicy foods,fried foods,regular consumption of salted vegetables,fruits,vegetables and woflfberry products,family history of gastric cancer,and infections of Hp were significantly correlated with the risk factors of gastric intestinal metaplasia( P<0.05).According to logistic regression multivariate analysis,the independent risk factors of gastric intestinal metaplasia included age≥55 years old( OR= 2.885),consumption of fried foods( OR= 2.355),eating salted vegetables frequently( OR= 1.883),infections of Hp( OR =2.693),and family history of gastric cancer( OR = 3.309).The protection factors included eating fruits( ≥3 times a week,OR = 0.523) and wolfberry products( ≥3 times a week,OR = 0.529).Conclusion Age,improper diet,family history of gastric cancer and infections of Hp are the main risk factors of gastric intestinal metaplasia in Ningxia.
Objective To analyze the risk factors of gastric intestinal metaplasia in Ningxia in order to contribute to the prevention and treatment of gastric cancer.Methods Patients of the case group( 112 patients) who were admitted into our hosptial between January 2012 and January 2014 due to gastric intestinal metaplasia were confirmed by endoscopy and pathology,while another 182 healthy people were selected as the control group.Telephone questionnaires were adopted to obtain related exposure factors,whereas single-factor and multi-factor analyses were performed by non-conditional logistic regression. Results According to the results of Chi-square test,age of 55 or above,smoking,alcoholic drinking,tea drinking,irregluar diet,high-salt taste,spicy foods,fried foods,regular consumption of salted vegetables,fruits,vegetables and woflfberry products,family history of gastric cancer,and infections of Hp were significantly correlated with the risk factors of gastric intestinal metaplasia( P<0.05).According to logistic regression multivariate analysis,the independent risk factors of gastric intestinal metaplasia included age≥55 years old( OR= 2.885),consumption of fried foods( OR= 2.355),eating salted vegetables frequently( OR= 1.883),infections of Hp( OR =2.693),and family history of gastric cancer( OR = 3.309).The protection factors included eating fruits( ≥3 times a week,OR = 0.523) and wolfberry products( ≥3 times a week,OR = 0.529).Conclusion Age,improper diet,family history of gastric cancer and infections of Hp are the main risk factors of gastric intestinal metaplasia in Ningxia.
引文
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[13]WALKER MM.Is intestinal metaplasia of the stomachreversible?[J].Gut,2003,52(1):1.
[14]范尧夫,吴燕敏,刘皓,等.中国华东地区人群胃癌癌前病变发病相关危险因素分析[J].胃肠病学和肝病学杂志2014,23(2):143.
[15]赖跃兴,徐萍,黄珏,等.上海市松江区胃黏膜肠上皮化生危险因素病例对照研究[J].中国慢性病预防与控,2014,22(5):537.
[16]HAN M A,OH M G,CHOI I J,et al.Association of family history with cancer recurrence and survival in patients with gastric[J].J Chin Oncol,2012,30(7):701.
[17]于俊秀,李振方.家族性胃癌研究进展[J].国际肿瘤学杂志,2013,40(1):65.
[18]罗艺珍,甘耀.胃癌患病的危险因素病例对照研究[J].当代医学,2013,19(1):9.
[2]DE VRIES A C,HARINGSMA J,KUIPERS E J.The detection,surveillance and treatment of premalignant gastric lesions related to Helicobacter pylori infection[J].Helicobacter,2007,12(1):1.
[3]高瑞萍.宁夏胃癌变化趋势及患病危险因素研究[D].银川:宁夏医科大学,2009.
[4]JOO Y E,PARK H K,MYUNG D S,et al.Prevalence and risk factors of atrophic gastritis and intestinal metaplasia:a nationwide multicenter prospectivestudy in Korea[J].Gut and Liver,2013,7(3):303.
[5]邹文斌,吴浩,蔡全才,等.胃癌危险因素研究进展[J].中国实用内科杂志,2014,34(4):415.
[6]岑朝,王超,周喜汉等,百色市胃癌发病危险因素病例对照研究[J].中华肿瘤防治杂志,2014,21(3):178.
[7]杨晓辉,葛箭,蔡慧珍,等.回族人群饮食习惯与胃癌发生的相关性研究[J].现代预防医学,2012,39(11):2674.
[8]STEEVENS J,SCHOUTEN J,GOLDBOHM R A,et al.Vegetables and fruits consumption and risk of esophageal and gastric cancer subtypes in the Netherlands Cohort Study[J].Int J Cancer,2011,129(11):2681.
[9]ZHANG Z,XU G,MA M,et al.Dietary fiber intake reduces risk for gastric cancer:a meta-analysis[J].Gastroenterology,2013,145(1):113.
[10]肖佩玉,万正兰,黄际薇等.枸杞多糖对肝癌模型小鼠肿瘤抑制与免疫功能的影响[J].中国药房,2014,25(43):4046.
[11]BORNSCHEIN J,MALFERTHEINER P.Gastric carcinogenesis[J].Langenbecks Arch Surg,2011,396(6):729.
[12]STAIRS DB,KONG J,LYNCH JP.Cdx genes,inflammation,and the pathogenesis of intestinal metaplasia[J].Prog Mol Biol Transl Sci,2010,96:231.
[13]WALKER MM.Is intestinal metaplasia of the stomachreversible?[J].Gut,2003,52(1):1.
[14]范尧夫,吴燕敏,刘皓,等.中国华东地区人群胃癌癌前病变发病相关危险因素分析[J].胃肠病学和肝病学杂志2014,23(2):143.
[15]赖跃兴,徐萍,黄珏,等.上海市松江区胃黏膜肠上皮化生危险因素病例对照研究[J].中国慢性病预防与控,2014,22(5):537.
[16]HAN M A,OH M G,CHOI I J,et al.Association of family history with cancer recurrence and survival in patients with gastric[J].J Chin Oncol,2012,30(7):701.
[17]于俊秀,李振方.家族性胃癌研究进展[J].国际肿瘤学杂志,2013,40(1):65.
[18]罗艺珍,甘耀.胃癌患病的危险因素病例对照研究[J].当代医学,2013,19(1):9.