食管癌高发区食管炎影响因素的病例对照研究

山东大学学报(医学版) ›› 2010, Vol. 48 ›› Issue (10): 120-124.

食管癌高发区食管炎影响因素的病例对照研究

张好1，周英智2，刁玉涛3，李会庆3，周瑞雪4，赵德利4，雷复华4

1. 济南市第三人民医院消化内科，济南 250101；2. 山东大学经济学院，济南 250100；
3. 山东省医科院基础所，济南 250062；4. 肥城市人民医院，山东肥城 271600

收稿日期:2010-09-15 出版日期:2010-10-16 发布日期:2010-10-16
通讯作者: 李会庆，教授，博士生导师，主要从事肿瘤流行病学研究。E-mail：huiqing4192@163.com
作者简介:张好（1968- ），女，硕士，主治医师，主要从事消化系统疾病研究。
基金资助:
国家自然科学基金资助项目（30571601）；山东省2004年科学技术发展（重大专项部分）资助项目（2004GG1108039）；2007年度山东省博士后创新项目专项资金资助项目(200702034) 。

Case-control study of influencing factors of esophagitis in a high incidence area of esophageal squamous cell cancer

ZHANG Hao1， ZHOU Ying-zhi2, DIAO Yutao3, LI Hui-qing3, ZHOU Rui-xue4, ZHAO De-li4 , LEI Fu-hua4

1. Department of Gastroenterology, Jinan Third People′s Hospital, Jinan 250101，China；
2. School of Economics, Shandong University, Jinan 250100, China；
3. Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China；
4. Feicheng People′s Hospital, Feicheng 271600, Shandong, China

Received:2010-09-15 Online:2010-10-16 Published:2010-10-16

摘要/Abstract

摘要：

目的探讨食管癌高发区肥城市食管炎的影响因素。方法在肥城市一食管癌高发乡镇40~69岁队列人群中，采用染色内镜和活检病理诊断方法确诊食管炎357例，作为病例组，另选取内镜检查食管黏膜正常者500例作为对照组。分析食管癌家族史、吸烟、饮酒、营养成分等与食管炎的关联，以OR及95%CI作为评价关联强度的指标。结果将性别、年龄作为调整因素，以无食管癌家族史为比较的基线水平（OR=1.0），一级亲属患食管癌的OR为1.830（95%CI ：1.183~2.833）；以吸烟指数=0为比较的基线水平，吸烟指数≥500的OR为1.852（95%CI ：1.142~3.005）；以饮酒指数=0为比较的基线水平，饮酒指数<130和≥130的OR分别为1.789（95%CI ：1.141~2.804）、1.642（95%CI ：1.029~2.621）；将吸烟（吸烟、不吸烟）、饮酒（饮酒、不饮酒）情况进行组合，以不吸烟+不饮酒为比较的基线水平，吸烟+饮酒的OR为1.889（95%CI ：1.143~3.122）；将各营养成分年摄入量划分为3个层次，以最低水平为比较的基线水平，发现脂肪、叶酸、铁的影响达到显著性水平（OR均小于1）。结论食管癌家族史、吸烟、饮酒是食管炎的危险因素，营养成分对食管炎的影响不明显。在食管癌高发区，特别是在有食管癌家族史的人群中，提倡戒烟戒酒，对预防食管炎进而减少食管增生和食管癌的发生具有重要的作用。

关键词: 食管炎；食管癌家族史；吸烟；饮酒；营养；危险因素

Abstract:

Objective To investigate the influencing factors of esophagitis in Feicheng City, a high incidence area of esophageal squamous cell cancer (ESCC) of Shandong Province, China. Methods In a high incidence community of ESCC, a cohort of residents aged from 40 to 69 were examined for esophageal lesions. The case group included 357 cases of esophagitis diagnosed by staining endoscope and pathogenic examination, and 500 persons with normal esophageal mucosa determined by gastric endoscope served as the control group. The associations of family history of esophageal cancer, smoking, drinking and nutrition ingredients with esophagitis were analyzed, and OR and 95%CI were used as the association indicators. Results Gender and age were regarded as adjusting factors. When no family history of esophageal cancer was used as the base line, the OR was 1.830 （95%CI：1.1832.833） for those whose first-graderelatives had suffered from esophageal cancer; when smoking index=0 was used as the base line, the OR was 1.852 （95%CI ：1.1423.005） for smoking index≥500; when drinking index=0 was used as the base line,the OR was 1.789（95%CI ：1.1412.804） and 1.642（95%CI：1.0292.621）for drinking index <130 and ≥130 respectively; when no-smoking and no-drinking was used as the base line, the OR was 1.889（95%CI ：1.1433.122） for both smoking and drinking； the annual intake of nutrition ingredients was classified into three levels, and when the lowest level was used as the base line, the ORs for fat, folic acid and iron reached significant levels. Conclusion Family history of esophageal cancer, smoking and drinking are risk factors, but nutrition ingredients do not play obvious role for esophagitis. Abstinence from smoking and drinking is important to prevent esophagitis, and then reduce esophageal dysplasia and cancer in high incidence areas of esophageal cancer especially in those who have family history of esophageal cancer.

Key words: Esophagitis；Family history of esophageal cancer；Smoking; Drinking; Nutrition； Risk factors

中图分类号:

R571

张好1，周英智2，刁玉涛3，李会庆3，周瑞雪4，赵德利4，雷复华4. 食管癌高发区食管炎影响因素的病例对照研究[J]. 山东大学学报(医学版), 2010, 48(10): 120-124.

ZHANG Hao1， ZHOU Ying-zhi2, DIAO Yutao3, LI Hui-qing3, ZHOU Rui-xue4, ZHAO De-li4 , LEI Fu-hua4. Case-control study of influencing factors of esophagitis in a high incidence area of esophageal squamous cell cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(10): 120-124.

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