胰腺癌流行病调查及高危评分模型研究  

Epidemiological Investigation of Adenocarcinoma of Pancreas and its High Risk Score Model

作　　者：陆星华[1] 王丽[2] 杨爱明[1] 钱家鸣[1] 李辉[2] 麦灿荣[1] 钟守先[1] 邓瑞雪[1] 周璐[1] 杨晓鸥[1] 蒋卫君[1] 

机构地区：[1]中国协和医科大学/中国医学科学院北京协和医院,100730 [2]中国协和医科大学/中国医学科学院基础医学研究所流行病教研组

出　　处：《医学研究通讯》2005年第7期11-14,61,共5页Bulletin of Medical Research

基　　金：卫生部直属医疗机构临床学科重点基金资助(20010102)

摘　　要：目的调查中国胰腺癌病死率、危险因素,建立胰腺癌高危评分模型。方法通过中国疾病监测点监测人群胰腺癌病死率及分布特征;采用病例对照,通过面对面问卷方式对胰腺癌危险因素进行调查分析;用 Logistic 回归方法建立高危评分模型。结果胰腺癌10年间(1991～2000年)病死率由1991年的1.83%增加到2000年的2.26%,其在肿瘤中的位次一直在第7、8位之间波动;男性高于女性;胰腺癌主要危及中老年,60岁以上占69.62%;不同地区胰腺癌病死率差别明显,东北和华东地区显著高于其他地区;城市报告病死率为农村的2.42～4.68倍。胰腺癌危险因素主要表现在高剂量吸烟人群;饮食中高热量、高胆固醇,如肉食可增加胰腺癌风险;糖尿病也为胰腺癌的危险因素。临床症状中厌食、上腹痛、腹胀、黄疸及体重下降为高危因素,每个危险因素以与胰腺癌相关的重要性给予评分,如总分高于33分,则属于高危人群,其敏感性为88.9%、特异性为97.6%。结论中国胰腺癌病死率仍有逐渐上升趋势,吸烟、生活方式、糖尿病是胰腺癌的危险因素,胰腺癌高危评分模型敏感性为88.9%、特异性为97.6%。Objective To investigate the risk factors and mortality rate for pancreatic cancer in China and establish a risk model. Method Pancreatic cancer mortality and distribution data were colleted through China's Disease Surveillance Point system(DSPs)from 1991 to 2000.We analyzed 119 pancreatic cancer cases diagnosed between January 2002 to April 2004 by using a case-control method,Information for risk factor analysis was obtained by interviewing all subjects involved in the study.Logistic regression analysis was used to calculate odds rates (OR),95% confidence intervals(Cls)and β,which was further used to establish a risk model.Result The mortality rates of the pancreatic cancer was increased from 1.83% in 1991 to 2.26% in 2000.The majority of the death from pancreatic cancer was seen in the man,age group of 60 years and older,in urban areas,the northeastern and eastern part of China.The major risk factors for the pancreatic cancer included heavy smoking,dietary intake and diabetes.Typical symptoms of pancreatic cancer are anorexia,upper abdominal pain,bloating,jaundice and weight lost.Each risk factor was assigned a value to represent its importance associated with the pancreatic cancer.Subsequently by adding all the points together,a risk model was established with a value higher than 33 as being at risk to developing pancreatic cancer.Conclusion The death rate due to pancreatic cancer was rising.Smoking,life-style and diabetes were major risk factor for the pancreatic cancer.A risk model for pancreatic cancer was established with 88.9% sensitivity and 97.6% of specificity.

关 键 词：胰腺癌 流行病调查 评分 模型 Logistic回归 1991~2000年 中国疾病监测点 危险因素 病死率 1991年 60岁以上 监测人群 病例对照 方法建立 不同地区 华东地区 吸烟人群 主要表现 高胆固醇 临床症状 高危因素 体重下降 高危人群 

分 类 号：R735.9[医药卫生—肿瘤] R516.4[医药卫生—临床医学]