伊朗北部食管癌高发地区饮茶习惯与食管癌的关系：基于人群的病例对照研究  

Tea drinking habits and oesophageal cancer in a high risk area in northern Iran： population based case-control study

作　　者：朱晔(译)[1] 班宗文(译)[1] 鲁重关(校)[1] 

机构地区：[1]北京协和医院消化科

出　　处：《英国医学杂志中文版》2009年第4期207-210,共4页The BMJ Chinese Edition

基　　金：志谢： We thank the staff of the Atrak Clinic, including Karim Aghcheli, Noushin Taghavi, Haji-Amin Marjani, Rabaeh Rajabzadeh, Monireh Badakhshan, Bita Mohammadi, Halimeh Eskandamejhad, Safora Kor, Soleiman Kasalkheh, and Ashor Yolmeh; Noorli Radgohar, Abdolazim Khozeini, Rahmat Ghaziani, Mohammad Hasan Brazandeh, Abdolhakim Ebadati, Naser Keramat, and Ahmad Nosrati for their valuable help ; the local health networks and health workers （Behvarzes） in the study area for their assistance in recruitment of controls; the Iranian Social Security Organization for their local support; and the Golestan Cohort Study Center staff for their dedicated work. 关于作者（ Contributors）： See bmj. com. 基金（ Funding）： This study was supported by the Digestive Disease Research Center of Tehran University of Medical Sciences （ grant No 82-603）, by an intramural programme of the National Cancer Institute, National Institutes of Health, and by the International Agency for Research on Cancer, The funding sources had no role in the design, conduct, statistical analysis and interpretation of results, or writing of the manuscript. 利益竞争（Competing interests）： None declared. 伦理学批准 （Ethical approval）： The ease-control study was reviewed and approved by the institutional review boards of the Digestive Disease Research Center （DDRC） of Tehran University of Medical Sciences and the US National Cancer Institute. Both cases and controls gave written informed consent for the interview. The conduct of Golestan Cohort Study was reviewed and approved by the institutional review boards of DDRC, the International Agency for Research on Cancer, and the US National Cancer Institute.

摘　　要：研究目的调查伊朗北部古丽斯坦（Golestan）省居民饮茶习惯与食管鳞状细胞癌发病危险之间的关系。研究设计基于人群的病例对照研究。此外，在一项队列研究中评估健康受试者的饮茶模式及其饮用时的茶温。研究地点伊朗北部古丽斯坦省，该地区为食管鳞状细胞癌高发地区。研究对象300例经组织学确诊的食管鳞状细胞癌患者和571名相匹配的邻居对照者人组病例对照研究，48582名健康受试者入组队列研究。主要转归指标与饮用热茶相关的食管鳞状细胞癌发病危险的比值比（OR）。研究结果队列研究中几乎所有受试者（98％）均规律饮用红茶，平均摄人量为1升／天。39．0％的受试者饮用时的茶温低于60℃，38．9％为60～64℃，22．0％为65℃或更高。受试者报告的茶温与实际测量值为中等一致（加权K值为0．49）。病例对照研究的结果显示，与饮用微温茶或温茶相比，饮用热茶（OR=2．07，95％可信区间为1．28—3．35）或者极热茶（8．16，3．93～16．9）与食管癌发病危险增高相关。同样地，与冲泡后4分钟或更长时间再饮用相比，冲泡后2—3分钟饮用（2．49，1．62～3．83）或者冲泡后2分钟内饮用（5．41，2．63～11．1）与食管癌发病危险增高相关。饮茶温度与泡茶到饮茶的时间间隔高度一致（加权κ值为0．68）。研究结论古丽斯坦省居民饮用热茶的习惯与当地食管癌的较高发病危险之间具有强相关性。Objective To investigate the association between tea drinking habits in Golestan province, northern Iran, and risk of oesophageal squamous cell carcinoma. Design Population based case-control study. In addition, patterns of tea drinking and temperature at which tea was drunk were measured among healthy participants in a cohort study. Setting Golestan province, northern Iran, an area with a high incidence of oesophageal squamous cell carcinoma. Participants 300 histologically proved cases of oesophageal squamous cell carcinoma and 571 matched neighbourhood controls in the case-control study and 48 582 participants in the cohort study. Main outcome measure Odds ratio of oesophageal squamous cell carcinoma associated with drinking hot tea. Results Nearly all （ 98% ） of the cohort participants drank black tea regularly, with a mean volume consumed of over one litre a day. 39. 0% of participants drank their tea at temperatures less than 60℃, 38. 9% at 60-64℃, and 22. 0% at 65 ~C or higher . A moderate agreement was found between reported tea drinking temperature and actual temperature measurements （weighted K 0.49）. The results of the ease-control study showed that compared with drinking lukewarm or warm tea, drinking hot tea （odds ratio 2. 07, 95% confidence interval 1.28 to 3.35） or very hot tea （8. 16, 3.93 to 16.9） was associated with an increased risk of oesophageal cancer. Likewise, compared with drinking tea four or more minutes after being poured, drinking tea 2-3 minutes after pouting （2. 49, 1.62 to 3. 83 ） or less than two minutes after pouring （5.41, 2.63 to 11.1） was associated with a significantly increased risk. A strong agreement was found between responses to the questions on temperature at which tea was drunk and interval from tea being poured to being drunk （weighted K 0.68）. Conclusion Drinking hot tea, a habit common in Golestan province, was strongly associated with a higher risk of oesophageal cancer.

关 键 词：病例对照研究 饮茶习惯 高发地区 食管癌 伊朗 人群 食管鳞状细胞癌 健康受试者 

分 类 号：R735.2[医药卫生—肿瘤] R155.1[医药卫生—临床医学]