吸烟人群食管癌发病风险及其影响因素研究  

Study on Risk of Esophageal Carcinoma and Its Influencing Factors to Smokers

作　　者：徐学琴[1] 张瑞[1] 陈玉龙[1] 宋学坤[1] 代民涛 董玉琼[1] 马纯政[2] 解英[3] 舒琦瑾[4] 薛文翰[5] 李平[6] 范焕芳[7] 罗保平[8] 郑智[9] 李晓龙 张洪亮 周超峰 许彦超 李小青 王泽坤 朱然培 张华[1] 周哲旭 张帆[1] 郑玉玲[1] XU Xueqin;ZHANG Rui;CHEN Yulong;SONG Xuekun;DAI Mintao;DONG Yuqiong;MA Chunzheng;XIE Ying;SHU Qijin;XUE Wenhan;LI Ping;FAN Huanfang;LUO Baoping;ZHENG Zhi;LI Xiaolong;ZHANG Hongliang;ZHOU Chaofeng;XU Yanchao;LI Xiaoqing;WANG Zekun;ZHU Ranpei;ZHANG Hua;ZHOU Zhexu;ZHANG Fan;ZHENG Yuling(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The Second Affiliated Hospital of Henan University of Chinese Medicine/Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou Henan China 450002;Shanxi Provincial Cancer Hospital,Taiyuan Shanxi China 030013;Zhejiang Provincial Hospital of Chinese Medicine,Hangzhou Zhejiang China 310006;Gansu Provincial Cancer Hospital,Lanzhou Gansu China 730000;The First Affiliated Hospital of Anhui Medical University,Hefei Anhui China 230000;Hebei Province Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei China 050000;Hubei Province Hospital of Traditional Chinese Medicine,Wuhan Hubei China 430061;Jiangxi Cancer Hospital,Nanchang Jiangxi China 330029;Ningxia Chinese Medicine Research Center,Yinchuan Ningxia China 750021;Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region,Wulumuqi Xinjiang China 830000)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450000 [3]山西省肿瘤医院,山西太原030013 [4]浙江省中医院,浙江杭州310006 [5]甘肃省肿瘤医院,甘肃兰州730000 [6]安徽医科大学第一附属医院,安徽合肥230000 [7]河北省中医院,河北石家庄050000 [8]湖北省中医院,湖北武汉430061 [9]江西省肿瘤医院,江西南昌330029 [10]宁夏回族自治区中医医院暨中医研究院,宁夏银川750021 [11]新疆维吾尔自治区中医医院,新疆乌鲁木齐830000

出　　处：《中医学报》2022年第12期2593-2597,共5页Acta Chinese Medicine

基　　金：国家中医临床研究基地科研专项资助项目(2019JDZX001,2019JDZX028);国家中医药百千万人才支持计划-岐黄学者资助项目{国中医药人教发〔2018〕284号};河南省科技攻关社会发展项目(202102310497);河南省高等学校重点科研项目(20A360005)。

摘　　要：目的:分析吸烟与食管癌发病风险的关联性,并在吸烟人群中对食管癌发病风险的影响因素进行研究,为开展食管癌的病因预防提供参考依据。方法:采用病例对照研究方法,在全国10个中心通过问卷调查的方法收集食管癌和非食管癌对象的资料,应用χ^(2)检验或秩和检验对是否吸烟、开始吸烟的年龄、吸烟量及吸烟年限与食管癌的关系进行分析,OR及其95%CI、病因分值(AR%)用以表示联系强度,应用Cox回归模型在吸烟人群中分析影响食管癌发病风险的因素,风险比(HR)及其95%CI用以表示发病风险。结果:食管癌患者和非食管癌吸烟史比较,差异有统计学意义[P<0.001,OR及其95%CI为2.32(2.04,2.65)],吸烟年限和每日吸烟量与食管癌存在相关性(P<0.001)。Cox回归分析结果显示:在吸烟人群中,年龄≥60岁、有饮酒史、热烫霉变饮食、进食速度快、吸烟量增加、吸烟年限≥30年均可增加食管癌的发生风险(P均<0.05)。结论:吸烟与食管癌的发生具有相关性,高龄、饮酒、不良饮食习惯、吸烟量大及吸烟时间长是吸烟人群食管癌发生风险增加的影响因素。Objective:To analyze the correlation between smoking and the risk of esophageal carcinoma,and to study the influencing factors of the risk of esophageal carcinoma in smoking population,so as to provide reference for the prevention of esophageal carcinoma.Methods:Using the case-control study method,the data of esophageal carcinoma and non-esophageal cancer subjects were collected by questionnaire survey in 10 centers across the country.χ^(2) test or rank sum test was used to analyze the relationship between smoking,smoking age,smoking amount and smoking years and esophageal cancer.The OR and its 95%CI,and the etiologic fraction(AR%)are used to represent the strength of the relationship.The Cox regression model is used to analyze the factors affecting the risk of esophageal carcinoma in the smoking population.The hazard ratio(HR)and its 95%CI are used to represent the disease risk.Results:There was a statistically significant difference in smoking history between esophageal carcinoma patients and non-esophageal carcinoma patients[P<0.001,OR and its 95%CI was 2.32(2.04,2.65)].Smoking years and daily smoking amount were associated with esophageal carcinoma(P<0.001).And Cox regression analysis showed that:in smoking population,age≥60 years old,drinking history,hot blanching and mildew diet,fast eating speed,increased smoking amount,and smoking years≥30 years can increase the risk of esophageal carcinoma(P<0.05).Conclusion:Smoking is associated with the occurrence of esophageal carcinoma.Old age,alcohol consumption,poor dietary habits,heavy smoking,and long smoking time are the influencing factors for the increased risk of esophageal carcinoma in smokers.

关 键 词：食管癌 吸烟人群 发病风险 影响因素 COX回归模型 

分 类 号：R273.351[医药卫生—中西医结合]