结直肠癌发生的相关危险因素分析  

Research on the Related Risk Factors of Colorectal Cancer

作　　者：凌露 王京[1] 吴静[2,3] 孟乾隆 张子然 刘揆亮 李文坤 崔子璐 葛将 Ling Lu;Wang Jing;Wu Jing;Meng Qianlong;Zhang Ziran;Liu Kuiliang;Li Wenkun;Cui Zilu;Ge Jiang(Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;不详)

机构地区：[1]首都医科大学附属北京朝阳医院,北京市100020 [2]首都医科大学附属北京友谊医院,北京市100050 [3]首都医科大学附属北京世纪坛医院,北京市100038

出　　处：《中国病案》2021年第8期104-108,共5页Chinese Medical Record

基　　金：铁路系统职工结直肠癌筛查及新型粪便筛查标志物的研究(N2019Z004)。

摘　　要：目的分析结直肠癌的主要危险因素,为结直肠癌的早期筛查和预防提供方向。方法回顾分析2020年6月1日至2020年12月31日某医科大学附属医院收治的首次确诊为结直肠癌的31名患者的临床资料,并与282例健康人进行对照分析,采用t检验和卡方检验比较两组的年龄、BMI、性别、吸烟史、饮酒史、职业中是否接触毒害物质、锻炼时间、蔬菜水果摄入等资料,将P<0.05的因素纳入二元多因素logistic回归分析,并采用随机森林的方法,以平均下降Gini指数来分别探索结直肠癌发病的主要危险因素。结果结直肠癌组与对照组在年龄、BMI、性别、饮酒史、是否接触毒害物质、腌制食品摄入、益生菌摄入等方面差异有统计学意义(P<0.05),进一步进行二元logistic回归分析发现,排便费力(OR:45.498,95%Cl:13.259~156.124)、结直肠癌家族史(OR:24.714,95%Cl:4.904~124.587)、癌症史(OR:86.141,95%Cl:10.387~714.410)为结直肠癌发病的主要危险因素。基于随机森林算法,发现年龄、排便费力、BMI、结直肠癌家族史、癌症史比大便频率、体重下降消瘦、职业中接触毒害物质、黑便血便、益生菌摄入等指标对于结直肠癌的影响更重要。结论排便费力、结直肠癌家族史、癌症史为结直肠癌发病的主要危险因素。Objective To analyze the main risk factors of colorectal cancer and provide directions for early screening and prevention of colorectal cancer.Methods To explore the main risk factors for colorectal cancer,the clinical data of 31 patients with colorectal cancer in affiliated hospital of a medical university from June 1,2020 to December 31,2020 were retrospectively analyzed,compared with 282 healthy people.The t test and chi-square test were used to compare the data of age,BMI,gender,smoking history,drinking history,occupation exposure to toxic substances,exercise time,vegetable and fruit intake etc.between the two groups,and factors with P<0.05 were included in the binary multivariate logistic regression analysis.The average decrease of Gini index was used to explore the main risk factors of colorectal cancer by random forest method.Results There were statistically significant differences between the colorectal cancer group and the control group in age,BMI,gender,drinking history,occupation exposure to toxic substances,intake of pickled food,and intake of probiotics(P<0.05).Logistic regression analysis found that difficulty in defecation(OR:45.498,95%Cl:13.259~156.124),family history of colorectal cancer(OR:24.714,95%Cl:4.904~124.587),and cancer history(OR:86.141,95%Cl:10.387~714.410)were the main risk factors for colorectal cancer.Based on the random forest algorithm,age,difficulty in defecation,BMI,family history of colorectal cancer and cancer history were more important than stool frequency,weight loss and emaciation,occupation exposure to toxic substances,black stool and blood stool,and probiotics intake for colorectal cancer.Conclusion Difficulty in defecation,family history of colorectal cancer,and cancer history were the main risk factors for colorectal cancer.

关 键 词：结直肠癌 危险因素 排便费力 家族史 癌症史 

分 类 号：R735.34[医药卫生—肿瘤]