【摘要】 目的:通过分析该地区单卵双胞胎食管癌发生特征及食管癌患者家族史调查,加深对食管癌变中遗传和环境因素作用影响的理解。方法:采用流行病学问卷调查和分析食管癌高发区30岁以上95对单卵双胞胎的疾病谱和体质量指数(bodymassindex,BMI),以及食管鳞癌患者家族史。结果:体质量和身高资料完整的21对双胞胎中,12对BMI值一致(BMI值±1)(57%),男女之间无差异。95对双胞胎中,7人发生恶性肿瘤,包括3例食管癌,1例肝癌,2例胆囊癌和1例淋巴瘤。除1对双胞胎同时发生胆囊癌外,其余均为单发。食管癌家族史调查发现9对双胞胎食管癌家族史阳性,3例食管癌患者均为食管癌家族史阳性。在2323例食管癌患者中,林州居民共1172例,食管癌阳性家族史352例(30%);林州以外河南地区共351例,家族史阳性63例(18%);河南省以外800例中,家族史阳性共136例(17%),林州居民食管癌阳性家族史的比例与其他地区间差异有统计学意义,P<0·05。结论:河南林州地区食管癌家族聚集现象明显高于河南其他地区及河南以外地区,河南林州1/3的食管癌患者有明显遗传倾向;环境因素可能仍是食管癌发生的重要因素。更多还原

【Abstract】 OBJECTIVE: To understand the interactions between genetic and environmental factors in human esophageal carcinogenesis.METHODS: Ninety-five pairs of monozygous twins in the high EC incidence area were interviewed for disease spectrum, and their body mass index (BMI) was calculated. In addition, EC patients were interviewed for their familial EC history.RESULTS: Of the 21 twins with recorded body weight and height, concordant BMI (BMI±1) was observed in 12 pairs (57%), and there was no difference between the male and the female pairs. Of the 95 pairs of twins, 7 persons were found to have the following malignant tumors: EC ( n= 3), liver cancer (n=1), gallbladder cancer (n=2), and lymphoma (n=1). These cancers occurred in six pairs of twins. Among them, only one female monozygotic twin had concordant gallbladder cancer. Nine pairs of the twins had positive EC familial history. All the three EC patients identified in three different monozygotic twins were positive for EC familial history. Of the 2323 EC patients, 1 172 were from Linzhou and 352 of them had positive familial EC history (30%, 352/1172), which was higher than those from other areas in Henan Province (18%, 63/351) or from other Provinces (17%, 136/800) (P<0.05). CONCLUSION: The occurrence of EC in one third of the EC patients in Linzhou may be related with genetic factors. However, the discordance in cancer occurrence in twins suggests a major role of environmental factors in esophageal carcinogenesis.更多还原