山东省农村地区40~69岁居民食管鳞癌及癌前病变的相关因素研究  

Study on the related factors of esophageal cancer and precancerous lesions in rural residents aged 40-69 years in Shandong Province

作　　者：卢培培 张楠 马恒敏 顾建华 徐辰龙 孟凡松 王家林 Lu Peipei;Zhang Nan;Ma Hengmin;Gu Jianhua;Xu Chenlong;Meng Fansong;Wang Jialin(School of Medicine and Life Sciences,Shandong Academy of Medical Sciences,University of Jinan,Jinan 250022,China;Department of Education and Prevention,Shandong Cancer Hospital And Institute,Shangdong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China;Department of Biostatistics,School of Public Health,Shandong University,Jinan 250012,China)

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院,250022 [2]山东省肿瘤防治研究院山东省肿瘤医院教育预防部,济南250117 [3]山东大学公共卫生学院生物统计学系,济南250012

出　　处：《中华预防医学杂志》2019年第11期1104-1109,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金(8157120974);山东省科技发展计划(2017GSF18101);国家重点研发计划(2016YFC1302800、2016YFC0901400);山东省自然科学基金(ZR2019PG006);山东省医学科学院院级科技计划(2018-06)。

摘　　要：目的 分析山东省农村地区40~69岁居民食管鳞癌及癌前病变的相关因素.方法 于2018年10月,以2017年山东省上消化道癌早诊早治项目的13个县300个行政村为研究地区,招募40~69岁30 400名居民.通过问卷调查收集人口学特征、健康状况和生活方式等信息,利用"内镜下染色+病理活检"技术对研究对象进行筛查并确诊,并采用多因素logistic回归模型分析食管鳞癌及癌前病变的相关因素.结果 研究对象年龄为(56.42±7.24)岁,其中男性13 193名(43.40%).食管鳞癌及癌前病变936例(3.08%),男、女性分别为521、415例.多因素logistic回归模型分析结果显示,与女性、40~49岁、文化程度为高中及以上、饮用自来水、经常摄入肉蛋奶类、家庭人均年收入≥30 000元者相比,男性、60~69岁、文化程度为小学及以下、饮用地下水、从不摄入肉蛋奶类、家庭人均年收入<30 000元者发生食管鳞癌及癌前病变的患病风险较高,OR(95%CI)值分别为1.90(1.65~2.19)、5.28(4.11~7.30)、1.50(1.20~1.89)、1.71(1.38~2.13)、1.48(1.22~1.80)、1.41(1.16~1.70).结论 性别、年龄、文化程度、家庭人均年收入、饮用水源、肉蛋奶类摄入与山东省农村地区40~69岁居民食管癌发生有关.Objective To analyze the related factors of esophageal squamous cell carcinoma and precancerous lesions among residents aged 40-69 years old in rural areas of Shandong Province. Methods In October 2018, 300 villages in 13 counties of the Shandong upper gastrointestinal cancerearly diagnosis and treatment projectin 2017 were selected as research areas, and 30 400 residents aged 40-69 were recruited in this study. The demographic characteristics, health status and lifestyle information were collected through the questionnaire survey, and endoscope iodine staining and indicative biopsy methods were used for cancer screening among eligible people.The multivariate logistic regression model was used to analyze the risk factors for esophageal cancer and precancerous lesions. Results The subjects in this study were (56.42±7.24) years old, including 13 193 males (43.40%).There were 936 cases of esophageal cancer and precancerous lesions (3.08%), including 521 males and 415 females.Compared with women, 40-49 years old, high level education, drinking tap water, regular intake of meat, eggs and milk, and family average annual income more than 30 000 RMB, men (OR=1.90, 95%CI : 1.65-2.19), 60-69 years old (OR=5.28, 95%CI : 4.11-7.30), primary school education or below ( OR=1.50, 95%CI : 1.20-1.89), drinking groundwater (OR=1.71, 95%CI: 1.38-2.13), never eating meat, eggs and milk (OR=1.48, 95%CI: 1.22-1.80), and family average annual income less than 30 000 RMB ( OR=1.41, 95%CI : 1.16-1.70) would increase the risk of esophageal cancer and precancerous lesions. Conclusion The gender, age, educational level, annual household income, drinking water source, the frequency of eating meat, egg and milk were related to the occurrence of esophageal cancer and precancerous lesions among 40-69 years old residents in rural areas of Shandong Province.

关 键 词：食管肿瘤 癌前状态 危险因素 筛查 

分 类 号：R[医药卫生]