【作者】 赵俊仕；

【导师】 黄民主；

【作者基本信息】 中南大学 ， 流行病与卫生统计学， 2008， 硕士

【摘要】 目的：探讨结肠癌发生的主要危险因素，为制定结肠癌的防制措施提供科学依据。方法：采用以医院为基础的1：1配对病例-对照研究方法，选择2006年5月1日～2007年9月1日期间入住中南大学湘雅医院、湘雅二医院、湘雅三医院经病理切片确诊的新发结肠癌病人作为病例，选择性别相同、年龄相差3岁以内，同期住院的非癌症病人作为对照，对研究对象进行问卷调查，内容包括：一般情况、生活饮食习惯、疾病史、家族恶性肿瘤史等。采用配对四格表χ~2检验和条件logistic回归对资料进行单因素及多因素分析，计算比值比((?)值)及OR值的95％可信区间(95％CI)。结果：单因素分析结果表明：文化程度低(χ~2=8．791，P=0．003)、职业为农民(χ~2=4．914，P=0．027)、收入水平低(χ~2=8．594，P=0．003)、不经常锻炼(χ~2=11．571，P=0．001)、常处于坐位状态(χ~2=10．983，P=0．001)、便秘(χ~2=7．321，P=0．007)、蔬菜摄入频率较低(8～13次／周χ~2=4．648，P=0．043；≤7次／周χ~2=28．372，P=0．000)、家畜肉摄入频率较高(χ~2=4．366，P=0．037)、口味偏咸(χ~2=6．195，P=0．013)、食用油以动物油为主(χ~2=15．284，P=0．000)、动物内脏摄入频率高(χ~2=20．645，P=0．000)、胃肠溃疡史(χ~2=4．654，P<0．05)、胆囊疾病史(χ~2=5．565，P=0．018)、阑尾炎史(χ~2=13．885，P<0．01)、一级亲属恶性肿瘤史(χ~2=13．829，P<0．01)与结肠癌的发病有关；而吸烟史(χ~2=1．221，P=0．267)、饮酒史(χ~2=0．860，P=0．354)、吃槟榔(χ~2=2．064，P>0．10)和腌菜酱菜(χ~2=3．571，P=0．059)等则与结肠癌的发病无关。多因素条件logistic回归分析结果显示：家畜肉摄入频率较高((?)=2．854，95％CI：1．269-6．419)，动物内脏摄入过多((?)=2．869，95％CI：1．364～6．034)，蔬菜摄入频率过低((?)=4．663，95％CI：2．049～10．661)、不经常锻炼((?)=4．480，95％CI：1．602～12．524)、常处于坐位状态((?)=6．110，95％CI：2．774～13．457)、食用油以动物油为主((?)=6．378，95％CI：2．716～14．981)、阑尾炎史((?)=8．338，95％CI：1．237～56．215)、一级亲属恶性肿瘤史((?)=15．833，95％CI：2．653～95．090)是结肠癌发病的危险因素。结论：蔬菜摄入频率过低、家畜肉和动物内脏摄入频率过高、缺乏锻炼、常处于坐位状态、食用油以动物油为主、阑尾炎史、一级亲属恶性肿瘤史是结肠癌发病的危险因素。吸烟、饮酒、吃槟榔、腌菜酱菜等因素与结肠癌发病无关联。更多还原

【Abstract】 Objective: To explore the major risk factors of colonic cancer and provide a scientific basis for strategies of colonic cancer prevention.Methods: A hospital-based 1:1 matched case-control study was adopted. 219 cases of colonic cancer that pathological diagnoised during May 1^th,2006 and Sep 1^th,2007 at the first, the second and the third affilfated hospital of XiangYa college were enrolled. Patients without colonic cancer or other cancer, however have the same gender, the same age （differ within 3 years） and receiving treatment at the same hospital as cases were selected as controls. Face-to-face interviews were carried out and the investigation involved the life style ,dietary habits, history of diseases and family history of cancer. Matched Chi-square test and conditioned logistic regression model were used for univariate andmultivariate analysis to estimate odds ratios （?） and the 95% confidence interval （95%C1）.Results: Univariate analysis showed that colonic cancer was associated with low education level （χ²=8.791 ,P=0.003 ）, peasantry （χ²=4.914,P=0.027）, low-income levels （χ²=8.594,P=0.003）, lack of exercise （χ²=11.571,P=0.001）, sedentary lifestyle （χ²=10.983,P=0.001）、constipation （χ²=7.321,P=0.007）, low vegetable intake （8-13times /week:χ²=4.648,P<0.043;≤7 times/week:χ²=28.372,P=0.000）, high meat intake （χ²=4.366,P=0.037）, high-salty foods intakes （χ²=6.195, P=0.013）, animal fats used cooking oil （χ²=15.284,P=0.000）, high animal bowels intake （χ²=20.645,P=0.000）, history of gastric and intestinal ulcer （χ²=4.654,P<0.05）, history of cystic disease （χ²=5.565, P=0.018）, history of appendicitis （χ²=13.885,P<0.01）, cancer history in the first degree relatives （χ²=13.829,P<0.01） . Meanwhile, colonic cancer was not associated with smoking （χ²=1.221, P=0.267）, drinking （χ²=0.860,P=0.354）, areca （χ²=2.064,P>0.10） and pickle （χ²=3.571, P=0.059） . Multivariate logistic regression analysis showed that high meat intake（（?）=2.854,95%CI: 1.269-6.419）, high animal bowels intake （（?）=2.869, 95%CI: 1.364-6.034）, low vegetable intake （（?）=4.663, 95%CI:2.049-10.661）, lack of exercise （（?） =4.480, 95 %CI:1.602-12.524）, sedentary lifestyle（（?） =6.110, 95%CI: 2.774 -13.457）, animal fats used cooking oil （（?）=6.378, 95%CI: 2.716- 14.981）, history of appendicitis （（?）=8.338, 95%CI:1.237-56.215）, cancer history of first degree relatives （（?）=15.833, 95%C7: 2.653-95.090） were the risk factors of colonic cancer.Conclusion: Colonic cancer could be affected by multi-factors, including low vegetable intake, high meat and animal bowels intake, lack of exercise, sedentary lifestyle, animal fats used cooking oil, history of appendicitis and cancer history in the first degree relatives. Meanwhile, colonic cancer was not associated with smoking, drinking, areca and pickle.更多还原