Zou J, Sun Q, Akiba S, Yuan Y, Zha Y, Tao Z, Wei L, Sugahara T
Guangdong Institute of Prevention and Treatment of Occupational Diseases, 165 Xingangxi Road, Guangzhou 510310, China.
J Radiat Res. 2000 Oct;41 Suppl:53-62. doi: 10.1269/jrr.41.s53.
The main purposes of this study were to identify the major determinants of nasopharyngeal carcinoma (NPC) in the high-background radiation areas (HBRA) in Yangjiang, China and to evaluate their potential confounding effects on the NPC risk associated with exposure to high background radiation. A matched case-control study was conducted using those who died of NPC during the period 1987-1995. Two controls were randomly selected for each case from those who died from causes other than malignancies and external causes. Cases and their controls were matched with respect to sex and the years of birth and death (+/- 5 years). Study subjects' next-of-kin were interviewed using a standardized questionnaire to collect information on socioeconomic status, dietary habits, tobacco smoking and alcohol consumption, disease history, pesticide use, medical X-ray exposure, the family history of NPC and so on. We succeeded in interviewing 97 cases and 192 controls. Univariate conditional logistic regression analysis showed that NPC risk was associated with the consumption of salted fish, homemade pickles, and fermented soy beans, education levels, the history of chronic rhinitis, and the family history of NPC. Multivariate conditional logistic regression analysis revealed that education levels (Odds ratio (OR) for middle school or higher levels vs. no school education = 3.8, 95% CI = 1.2 to 11.8), salted fish intake (OR = 3.2, 95% CI = 1.7 to 6.1), the history of chronic rhinitis (OR = 3.6, 95% CI = 1.3 to 10.1), and the family history of NPC (OR = 14.2, 95% CI = 2.7 to 73.4) were independent risk factors of NPC. Tobacco smoking (OR = 1.2, 95% CI = 0.7 to 2.1), and alcohol consumption (OR = 0.9, 95% CI = 0.5 to 1.9) were not significantly related to NPC risk. The ORs of NPC risk comparing HBRA and a nearby control area before and after adjustment for the major risk determinants identified in the present study were 0.86 (95% CI = 0.50 to 1.50) and 0.87 (95% CI = 0.45 to 1.67), respectively. Salted fish intake was a strong risk factor of NPC. Education, the history of chronic rhinitis and the family history of NPC were also related to NPC risk. The exposure to high background radiation in HBRA of Yangjiang was not related to NPC risk with or without the adjustment for those major risk determinants of NPC.
本研究的主要目的是确定中国阳江高本底辐射地区（HBRA）鼻咽癌（NPC）的主要决定因素，并评估它们对与高本底辐射暴露相关的NPC风险的潜在混杂影响。采用1987 - 1995年期间死于NPC的患者进行匹配病例对照研究。从死于恶性肿瘤和外部原因以外原因的人群中为每个病例随机选取两名对照。病例及其对照在性别、出生和死亡年份（±5年）方面进行匹配。使用标准化问卷对研究对象的近亲进行访谈，以收集有关社会经济状况、饮食习惯、吸烟和饮酒、疾病史、农药使用、医学X线暴露、NPC家族史等信息。我们成功访谈了97例病例和192名对照。单因素条件逻辑回归分析表明，NPC风险与咸鱼、自制泡菜和发酵大豆的食用、教育程度、慢性鼻炎病史以及NPC家族史有关。多因素条件逻辑回归分析显示，教育程度（中学或更高水平与未接受学校教育相比的优势比（OR）= 3.8，95%可信区间（CI）= 1.2至11.8）、咸鱼摄入量（OR = 3.2，95% CI = 1.7至6.1）、慢性鼻炎病史（OR = 3.6，95% CI = 1.3至10.1）以及NPC家族史（OR = 14.2，95% CI = 2.7至73.4）是NPC的独立危险因素。吸烟（OR = 1.2，95% CI = 0.7至2.1）和饮酒（OR = 0.9，95% CI = 0.5至1.9）与NPC风险无显著关联。在对本研究中确定的主要风险决定因素进行调整前后，比较HBRA和附近对照地区的NPC风险OR分别为0.86（95% CI = 0.50至1.50）和0.87（95% CI = 0.45至1.67）。咸鱼摄入量是NPC的一个强危险因素。教育、慢性鼻炎病史和NPC家族史也与NPC风险有关。阳江HBRA地区的高本底辐射暴露，无论是否对NPC的那些主要风险决定因素进行调整，均与NPC风险无关。
