鼻咽癌危险因子的危险度计算及其意义  

The synthetical odds ratios for risk factors of nasopharyngeal carcinoma and it＇s application

作　　者：杨业春[1] 陈楚玉[1] 钟玉霖[1] 

机构地区：[1]广州中医药大学第一附属医院信息科,广东省广州市510405

出　　处：《中国医院统计》2011年第1期58-61,共4页Chinese Journal of Hospital Statistics

摘　　要：目的 确定鼻咽癌主要危险因素及其综合危险度,用于估算个人患鼻咽癌的风险,为今后鼻咽癌的筛查和防治提供参考依据.方法 在电子数据库Pubmed和CBMDisc内中检索鼻咽癌相关文献,通过数据库检索和手工查阅纸质期刊的方式获取全文.通过综述性文献,结合鼻咽癌相关文献中的研究因素,确定鼻咽癌主要危险因素.筛选符合纳入标准的文献并进行Meta分析,计算鼻咽癌主要危险因素的综合危险度（OR值）.结果 鼻咽癌的主要危险因素包括鼻咽癌家族史、EB病毒感染（VCA-IgA≥1∶10）、多食腌制食品（咸鱼、腌肉和腌菜）和吸烟习惯.共纳入38篇文献进行Meta分析,其中21篇英文,17篇中文.纳入文献中除1篇为队列研究外,其他均为1∶1病例对照研究,研究对象以中国人为主.鼻咽癌主要危险因素鼻咽癌家族史、EB病毒感染、多食腌制食品和吸烟纳入Meta分析的文献数分别为6篇、20篇、9篇和9篇,除EB病毒外,纳入文献中的病例和对照性别年龄基本匹配.经检验纳入文献均符合异质性Q检验（P〉0.05）,采用固定效应模型计算鼻咽癌家族史、EB病毒感染、多食腌制食品和吸烟的综合危险度OR（95%CI）分别为7.20（4.80,10.81）、131.34（98.29,175.49）、1.67（1.47,1.89）和1.46（1.30,1.64）,综合危险度有统计学意义.鼻咽癌家族史、EB病毒感染、多食腌制食品和吸烟的失安全系数分别为230、18 986、218和131.结论 运用鼻咽癌综合危险度和个体情况可粗略估算个人患鼻咽癌的风险,根据风险大小采取不同的筛查措施;在高风险人群中开展鼻咽癌筛查,可以提高鼻咽癌筛查的成本效果和效益.Objective To find out main risk factors of nasopharyngeal carcinoma and estimate synthetical odds ratios （ORs） for them. The result can be used to assess individual risk for nasopharyngeal carcinoma and can provide reference for its screening and prevention. Methods To search published papers relevant to nasopharyngeal carcinoma in Pubmed and CBMDi- sc. By electronic database searching on computer and manual searching in library, full texts were got. By combining reviews and literatures related to risk factors for nasopharyngeal carcinoma, the main risk factors for nasopharyngeal carcinoma were con- firmed. To screen those papers which fit enroll-standard and do Meta analysis to estimate synthetical odds ratios （ORs） for risk factors of nasopharyngeal carcinoma. Results The main risk factors for nasopharyngeal carcinoma included family history, Ep- stein-Barr virus （VCA-IgA~〉I ： 10）, salted food eating （including salted fish, brawn, pickles, etc. ） and smoking. Totally 38 papers were brought into Meta analysis with 21 English ones and 17 Chinese ones respectively. These literatures were all 1 ： 1 case-control studies except 1 Cohort study and the study subjects were mainly Chinese. There were respectively 6, 20, 9 and 9 Papers used in Meta analysis for family history, Epstein-Barr virus, salted food eating and smoking. Except Epstein-Barr virus, the sex and age of the subjects match with one anther in relevant literatures. The heterogeneity test for the four risk factors were not significant（P〉0.05） and the ORs by fixed effect model for family history, Epstein-Barr virus, salted food eating and smoking was 7.20 （ 4.80, 10.81 ）, 131.34 （98.29,175.49）, 1.67 （ 1.47, 1.89） and 1.46 （ 1.30, 1.64） respectively. In addition, the safe number for family history, Epstein-Barr virus, salted food eating and smoking was 230, 18 986,218 and 131. Conclu- sion The ORs, combined with individual history, could be used to assess individual risks for nasopharyngeal carcinoma. Ac- cording t

关 键 词：鼻咽癌 危险因素 META分析 筛查 

分 类 号：R739.63[医药卫生—肿瘤]