摘要目的 探讨食管癌高发区食管癌发生的危险因素,为食管癌的综合防治提供理论依据.方法 采用以人群为基础的病例一对照家系研究方法,在河南省食管痛高发区以匹配方式选择病例和对照家系各505户,家庭成员各1171名,进行以家庭为单位的问卷调查,应用单因素和多因素logistic回归模型分析食管癌危险因素.结果 病例组和对照组比较,食用炯熏食物[2.10%(36/1711),0.82%(14/1711);X2=9.82,P=0.00;OR=2.61,95%C/:1.40～4.85],常吃油炸食品[7.17%(66/921),3.91%(35/894);X2=9.13,P=0.00;OR=1.90,95%C/:1.24～2.89],常吃生硬食物[13.36%(123/921),8.95%(80/894);X2=8.87,P=0.03;OR=1.57,95%CI/:1.16～2.11],喜食热烫食物[20.05%(343/1711),15.20%(260/1711);X2=13.87,P=0.00;OR:1.40,95%C/:1.17～1.67],有精神刺激史[6.72%(115/1711),3.10%(53/1711);X2=24.06,P=0.00;OR=2.25,95%CI:1.62～3.14]和有E消化道不适症状[19.40%(332/1711),12.74%(218/1711);X2=28.15,P=0.00;OR=1.65,95%CI:1.37～1.99]等因素,是食管癌发生的危险因素.而进食速度较快则显示是保护因素[20.85%(192/921),25.14%(225/895);X2=4.73,P=0.03;OR=0.78,95%Cl:0.63～0.98].结论 食管癌发生是多因素综合作用所致,要从生活行为方式、环境因素、社会心理因素和生物遗传因素等多方面进行综合防治.

abstractsObjective To explore the risk factors of esophageal cancer(EC) in the high-incidence regions,so as to provide scientific evidence for taking effective prevention measures. Methods A populationbased case-control family study was carried out. 1711 case family members in 505 families in which one of the couple or their first degree relatives suffered from EC were selected from high incidence in Henanprovince. Control families without neoplasm were selected from the same villages in matching conditions ofage,sex,and family members. All information of case and control families was collected by Questionnaire ofLife and Health of Inhabitant. The data were analyzed with logistic regression model. Results Comparedwith the control families,it was shown that hobby for smoked food[2. 10% (36/1711) ,0. 82% (14/1711) ;X2=9. 82, P=0. 00; OR=2. 61,95 % CI: 1.40 -4. 85], hobby for fried food [7. 17 % (66/921), 3.91%(35/894) ; X2=9. 13, P=0.00; OR=1.90,95 % CI: 1.24 -2. 89], hobby for raw and hard food [13.36 %(123/921) ,8.95 % (80/894) ; X2=8. 87, P=0. 03 ; OR=1.57,95 % CI: 1.16 -2. 11], and hobby for hotfood[20. 05% (343/1711), 15. 20% (260/1711) ; X2=13.87, P=0. 00; OR=1.40,95% CI: 1.17 -1.67], the history with mental stimulated[6. 72% (115/1711), 3. 10% (53/1711) ; X2=24.06, P=0. 130 ;OR=2. 25,95% CI: 1.62 -3. 14], upper digestive symptom history [19. 40% (332/1711), 12. 74% (218/1711);X2=28. 15, P=0.00; OR=1.65,95% CI: 1.37 -1.99]entered the last model, and wereresponsible for the higher risk of EC. Eating fast was shown to be a protective factor [20. 85% (192/921),25.14%(225/895) ;X2=4.73,P=0.03;OR=0.78,95%CI: 0.63 -0.98]. Conclusion EC is a kind of malignant tumor caused by multiple factors. Prevention and control of EC should be initiated from environmental factors, life style ,genetic factors and social-psychological factors comprehensively.