Qiu D-C, Hubbard A E, Zhong B, Zhang Y, Spear R C
Sichuan Institute of Parasitic Diseases, 10 University Road, Chengdu, Sichuan 610041, China.
Ann Trop Med Parasitol. 2005 Jan;99(1):47-52. doi: 10.1179/136485905X19883.
A study of liver and colon cancers and their association with a previous diagnosis of schistosomiasis was performed in rural Sichuan, China. The data analysed came from 127 liver-cancer and 142 colon-cancer patients, each matched, by age, gender, hospital and township, with one or two controls. The cancer cases were identified from the hospital records of three Sichuan counties (all of which have some level of endemic schistosomiasis japonicum): Meishan (66 liver and 54 colon cases), Pujiang (16 liver and 22 colon cases) and Xichang (45 liver and 66 colon cases). Each control was selected using the hospital records for the same year the matched case of cancer was diagnosed, when the control had been found to have an illness other than cancer. Previous schistosomal infection was determined by examining the medical records at the county hospitals, searching the records at the local schistosomiasis-control stations or health-surveillance units, and, when no written record could be found, by interviews with the subjects or their relatives. Given the extremely strong association between hepatitis and liver cancer in China, only data from hepatitis-negative pairs were used in the analyses. Previous schistosomal infection was found to be significantly associated with both liver cancer (odds ratio = 3.7; 95% confidence interval = 1.0-13) and colon cancer (odds ratio = 3.3; 95% confidence interval = 1.8-6.1). The results indicate a fraction of disease attributable to schistosomiasis of 24% for colon cancer, and (among the hepatitis-negative population) one of 27% for liver cancer.
在中国四川农村地区开展了一项关于肝癌和结肠癌及其与既往血吸虫病诊断之间关联的研究。所分析的数据来自127名肝癌患者和142名结肠癌患者，按照年龄、性别、医院和乡镇，为每名患者匹配了一至两名对照。癌症病例是从四川三个县（均有一定程度的日本血吸虫病流行）的医院记录中识别出来的：眉山（66例肝癌和54例结肠癌）、浦江（16例肝癌和22例结肠癌）和西昌（45例肝癌和66例结肠癌）。每个对照是利用与匹配的癌症病例确诊同年的医院记录挑选出来的，当时对照被发现患有除癌症以外的疾病。既往血吸虫感染情况通过查阅县医院的病历、查询当地血吸虫病防治站或健康监测单位的记录来确定，当找不到书面记录时，则通过与受试者或其亲属访谈来确定。鉴于在中国肝炎与肝癌之间存在极强的关联，分析中仅使用了来自肝炎阴性配对的数据。结果发现，既往血吸虫感染与肝癌（比值比=3.7；95%置信区间=1.0-13）和结肠癌（比值比=3.3；95%置信区间=1.8-6.1）均显著相关。结果表明，结肠癌归因于血吸虫病的疾病比例为24%，（在肝炎阴性人群中）肝癌的这一比例为27%。
