淮安市沿淮河居民食管癌及癌前病变影响因素的多元有序logistic回归分析  

Analysis of the influencing factors of esophageal cancer and precancerous lesions among Huaihe river residents in Huai'an by multivariate ordinal logistic regression analysis

作　　者：骆善彩 潘恩春[2] 周金意[3] 张芹[2] 何源[2] 王闯[2] 陈思红 何士林 

机构地区：[1]江苏省淮安市疾病预防控制中心公卫科,江苏省淮安223001 [2]江苏省淮安市疾病预防控制中心慢病科 [3]江苏省疾病预防控制中心慢病所 [4]江苏省洪泽县疾病预防控制中心慢病科 [5]江苏省金湖县疾病预防控制中心慢病科

出　　处：《中国慢性病预防与控制》2016年第8期573-576,共4页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：江苏省卫生厅预防医学基金项目(Y2013034);淮安市应用研究与科技攻关(社会发展)项目(H AS2014013-4)

摘　　要：目的探讨淮安市沿淮河居民食管癌及癌前病变发病的危险因素,为食管癌的防治提供依据。方法采用整群抽样方法抽取洪泽、金湖两地食管癌高发区居民作为研究对象,进行危险因素问卷调查,对问卷调查评价出的高危人群进行碘染色内镜筛查,并取活检组织进行病理诊断,依据病理诊断标准分为不同病变等级,并采用多元有序logistic回归对食管癌及癌前病变影响因素进行分析。结果该研究共收集参加碘染色内镜筛查居民4 001例,对照组（内镜检查正常）3 042例,轻中度异常增生组746例,重度异常增生及以上组213例。单因素分析结果显示,食管癌及癌前病变的发生与学历、饮用水来源、吸烟、饮酒、水果食用频率、肉类食用频率、腌制食品食用频率、油炸食品食用频率、性格类型、胃十二指肠溃疡、食管炎、胃肠炎疾病史和肿瘤家族史有关,有统计学意义（P〈0.05,P〈0.01）。多因素有序logistic回归分析结果表明,吸烟（OR=1.22,95%CI：1.02-1.46）、饮酒（OR=1.38,95%CI：1.14-1.68）、经常吃腌制食品（OR=1.76,95%CI：1.47-2.13）、经常吃油炸食品（OR=2.10,95%CI：1.41-3.15）、胃十二指肠溃疡疾病史（OR=1.57,95%CI：1.28-1.93）、食管炎疾病史（OR=1.44,95%CI：1.07-1.92）、胃肠炎疾病史（OR=1.46,95%CI：1.24-1.73）、肿瘤家族史（OR=2.70,95%CI：2.32-3.15）是食管癌及癌前病变发生的独立危险因素。结论淮安市沿淮河居民食管癌及癌前病变发生受遗传因素、膳食结构、生活方式及多因素共同影响,建议采取综合措施,积极改变不良的生活方式,对于高危人群,应该积极参加筛查,做到早诊早治。Objective To explore the risk factors of esophageal cancer and precancerous lesions among Huaihe river residents in Huai＇an, and to provide the basis for preventing esophageal cancer. Methods A cluster sampling method was used to select the residents of high-incidence areas in Hongze and Jinhu counties as the subjects. The present investigation was conducted with the risk factors questionnaire. Then high risk residents were screened with iodine staining endoscopic examination. The biopsy samples were diagnosed pathologically, according to pathological diagnosis criteria, the subjects with high risk were divided into the groups with different pathological degrees. The multivariate ordinal logistic regression analysis was used to analyze the independent influencing factors of esophageal cancer and precancerous lesions. Results The subjects screened with iodine staining endoscopic examination were 4 001 cases, which included the 3 042 control cases with normal endoscopic examination results, 746 cases with mild and moderate hyperplasia, 213 cases with severe hyperplasia. The univariate analysis showed that the esophageal cancer and precancerous lesions were significantly associated with educational level, drinking water source, smoking, drinking, intake frequencies of fruits and meats, intake frequencies of pickled foods and fried foods, personality type, gastric duodenal ulcer,esophagitis, gastroenteritis and family history of cancer（P〈0.05 or P〈0.01）. The multivariate analysis showed that smoking（OR=1.22, 95%CI： 1.02-1.46）, drinking（OR=1.38, 95%CI： 1.14-1.68）, more pickled food intake（OR=1.76, 95%CI： 1.47-2.13）,more fried food intake（OR=2.10, 95%CI： 1.41-3.15）, gastric duodenal ulcer disease（OR=1.57, 95%CI： 1.28-1.93）, esophagitis disease（OR=1.44, 95%CI： 1.07-1.92）,gastroenteritis disease（OR=1.46,95%CI： 1.24-1.73） and family history of cancer（OR=2.70,95%CI： 2.32-3.15） were the independent risk factors for the esophageal cancer and precancerous lesions. Conc

关 键 词：食管癌 癌前病变 危险因素 多元有序logistic回归 

分 类 号：R735.1[医药卫生—肿瘤]