【摘要】 目的:探讨家族史、BMI、吸烟、饮酒与贲门癌发病风险及预后的关系。方法:采用问卷调查记录16605例贲门癌患者和26053例非癌就诊者的家族史、吸烟、饮酒情况,并测量其身高和体质量。对贲门癌患者中电话或住址明确的2000例进行电话或入户随访,以死亡或搬迁为随访中止事件。生存分析及死亡风险评估采用Kaplan-Meier法和Cox模型。结果:家族史阳性明显增加贲门癌的发病风险(P<0.001,OR=2.012,95%CI=1.874～2.160);不同BMI患癌风险有较大差异,低体质量组的患癌风险是正常组的近4倍(OR=3.864,95%CI=3.459～4.317),超重组的患癌风险低于正常组(OR=0.323,95%CI=0.293～0.357);吸烟明显提升贲门癌的发病风险(P<0.001,OR=1.979,95%CI=1.785～2.194),而饮酒对贲门癌发病风险的影响较小(P<0.001,OR=0.749,95%CI=0.678～0.827)。家族史阳性患者生存期优于阴性者(P=0.010,RR=0.677,95%CI=0.502～0.912)。结论:家族史阳性、吸烟和低体质量均提示较高的贲门癌发病风险,而饮酒的作用较弱;家族史阳性可能是贲门癌患者预后较好的独立影响因素。更多还原

【Abstract】 Aim:To explore the influence of family history (FH),body mass index (BMI),smoking,and alcohol drinking on the risk and prognosis of gastric cardia cancer(GCC).Methods:A total of 16 605 patients with GCC and 26 053 controls were enrolled for retrospective investigation on FH,smoking,alcohol drinking,and BMI.Out of the 16 605 cases,2 000 subjects were followed-up by telephone or interviewed at home until November 2011.Survival analysis and hazard ratio(HR) estimated using Kaplan-Meier and multivariate Cox proportional hazard regression model were perfomed.Results:Positive FH was strikingly related with the high risk for GCC(P<0.001,OR=2.012,95%CI =1.874~2.160); the underweight group had nearly 4-folds elevated GCC risk than the normal weight group (OR=3.864,95%CI=3.459~4.317),and it was noteworthy that overweight was a protective factor for GCC(OR=0.323,95%CI=0.293~0.357);smoking was closely related with high risk for GCC(P<0.001,OR=1.979,95%CI=1.785~2.194); otherwise,the role of alcohol drinking was weak for GCC risk (P<0.001,OR=0.749,95%CI=0.678~0.827).Further analysis of the relationship between FH,BMI,smoking,alcohol drinking and survival showed that only FH was related with longer survival of patients with GCC(P=0.010,RR=0.677,95%CI=0.502~0.912).Conclusion:Positive FH,smoking and underweight are related with the higher risk for GCC,while alcohol drinking is a weak risk factor for GCC;positive FH could be an independent factor for better prognosis of GCC.更多还原