中国林州市食管癌高发区人群病因学预防效果观察  

Etiological Prevention Trial for Esophageal Cancer among High-risk Population in Linzhou City,China

作　　者：杨文献[1] 陆士新[1] 刘桂亭[1] 黎钧耀[2] 杨中枢 程同吉 连广庭 甄应中[1] 徐友梅[1] 王瑞林[1] 裘宋良[5] 张云汉[1] 董子明[1] 杨观瑞[5] 杨胜利[1] 陆维权[6] 胡东生[1] 李文杰[1] 吕全军[1] 王留兴[1] 赵立群[5] 连士勇 刘志才 李变云 常贵生[6] 王占伟[1] 崔自由[1] 

机构地区：[1]郑州大学医学院,河南郑州450052 [2]中国医学科学院肿瘤研究所,北京100021 [3]美国新泽西RUTGERS大学 [4]河南省林州食管癌防治研究委员会.研究所,河南林州456550 [5]河南省医学科学研究所,河南郑州450052 [6]河南省肿瘤研究所,河南郑州450008

出　　处：《中国肿瘤》2008年第7期548-552,共5页China Cancer

摘　　要：[目的]探讨降低食管癌发病率的有效预防对策和措施。[方法]根据食管癌流行病学和病因学研究发现的主要可疑致癌因素、促癌因素和保护因素,组织实施五项综合性病因学预防措施。应用自身前后对照的类实验研究方法,以林州市居民食管癌标化发病率为终点指标,以食管癌的主要致癌、促癌因素和保护因素的暴露水平为中间指标,评价其预防效果。[结果]林州市居民20年来食管癌标化发病率呈显著下降趋势,2003年与1980年相比男性下降了56.33%,女性下降45.07%;林州市居民体内致癌性亚硝胺和霉菌毒素的暴露水平明显下降;体内维生素A、B2水平明显增高,个人行为与社会环境危险因素明显减少、保护因素明显增加。[结论]林州食管癌高发区居民食管癌发病率的显著降低可能与实施针对病因的五项综合性预防措施有关。[Purpose ] To explore the effective countermeasure and means of prophylaxis to decrease incidence of the esophageal cancer. [Methods ] To counter the primary carcinogenic, promote, and protective factors identified by epidemiological and etiological investigation of esophageal cancer, five comprehensive countermeasure and means of etiological prevention were carried out and their preventive effects were evaluated in Linzhou city using quasi-experiment method nonequivalent control group, pre-post self-controlled to compare the outcome of pre- and post-intervention with standardized incidence rates of esophageal cancer among inhabitants in Linzhou city as end-point and exposure levels of the primary carcinogenic, promote, and protective factors as intermediate end-point. [Results ] In the past 20 years, the standardized incidence rates of esophageal cancer among inhabitants in Linzhou city significantly declined. Compared with those of 1980＇s, incidence rates in 2003 were decreased for 56.33% among males and 45.07% among females. At the same time, exposure levels of the carcinogenic nitrosamines and mycotoxins in vivo among inhabitants in Linzhou city clearly declined and their concentrations in vivo of the vitamins A and B2 obviously increased. The risk factors from individual behaviors and social environment evidently decreased and the protective factors significantly increased. [Conclusion ] The five comprehensive measures of prophylaxis carried out in high risk population of esophageal cancer in Linzhou city might be associated with the decline of incidence rate of esophageal cancer among residents.

关 键 词：食管肿瘤 流行病学 病因学预防 发病率 河南 

分 类 号：R730.1[医药卫生—肿瘤] R735.1[医药卫生—临床医学]