【摘要】 目的 发现非肿瘤肺部疾病对肺癌危险度的直接影响。方法 在甘肃省进行的病例-对照流行病学研究,涉及到在1994年1月至1998年4月期间发生的886名肺癌病例(男性656名,女性230名)。病例调查表中收集了多种诱发肺癌危险因素的资料,其中包括非肿瘤肺部疾病史(肺结核,慢性气管炎/肺气肿,哮喘,肺炎),初次发病诊断年龄和年份,接受治疗和住院情况等。通过分析这些资料,找出非肿瘤肺部疾病史与肺癌危险度的关系。结果 在对主动吸烟和社会经济因素进行调整后,发现肺癌危险度的增加与肺结核及慢性气管炎/肺气肿直接有关,其比值比(OR)和95%置信区间(CI)分别为OR=2.1(95% CI:1.4～3.1)与OR=1.4(95％ CI:1.1～1.8)。哮喘与肺炎也使肺癌OR值增加,其值分别为OR=1.4,(95% CI:0.9～2.1)与OR=1.5(95％ CI:1.0～2.3)。当只对有病理诊断的病例和由本人回答的资料进行分析时,肺结核与慢性气管炎/肺气肿导致肺癌危险度的增加也是显著的。结论本研究提供了新的证据,证明以往的肺结核与慢性气管炎/肺气肿使致肺癌危险度显著增加。哮喘和肺炎与肺癌的关系虽然也是正相关,但还没达到统计显著水平。更多还原

【Abstract】 Objective To identify prior lung diseases may be an independent risk factor for lung cancer.Methods A population- based case- control study in Gansu Province, China identified 886 lung cancer cases (656 male, 230 female) diagnosed between January, 1994 and April, 1998.A standardized interview collected information on a variety of potential risk factors including a history of physician - diagnosed nonmalignant lung diseases (pulmonary tuberculosis, chronic bronchitis/emphysema, asthma, pneumonia) , age and year in which each condition was first diagnosed, and any therapy or hospitalization received.Results Pulmonary tuberculosis (odds ratio [OR] =2.1, 95% CI 1.4-3.1) and chronic bronchitis/emphysema ( OR = 1.4, 95% CI 1.1 - 1.8) were associated with increased risk of lung cancer after adjustment for active smoking and socioeconomic status. ORs for asthma ( OR = 1.4, 95% C/0.9-2.1) and pneumonia (OR =1.5, 95% C/1.0-2.3) were also elevated. The risk of lung cancer remained significant for pulmonary tuberculosis and chronic bronchitis/emphysema when analysis was limited to the pathologically confirmed cases and self- responders. Conclusion This study provides evidence that previous pulmonary tuberculosis and chronic bronchitis/emphysema are related to lung cancer.The results for asthma and pneumonia, while suggestive of a positive association, did not reach the level of statistical significance.更多还原