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中国汉族人群胰腺癌风险模型的建立。

Establishment of risk model for pancreatic cancer in Chinese Han population.

作者信息

Lu Xing-Hua, Wang Li, Li Hui, Qian Jia-Ming, Deng Rui-Xue, Zhou Lu

机构信息

Department of Gastroenterology, Peking Union Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.

出版信息

World J Gastroenterol. 2006 Apr 14;12(14):2229-34. doi: 10.3748/wjg.v12.i4.2229.

Abstract

AIM

To investigate risk factors for pancreatic cancer and establish a risk model for Han population.

METHODS

This population-based case-control study was carried out from January 2002 to April 2004. One hundred and nineteen pancreatic cancer patients and 238 healthy people completed the questionnaire which was used for risk factor analysis. Logistic regression analysis was used to calculate odds ratio (ORs), 95% confidence intervals (Cls) and beta value, which were further used to establish the risk model.

RESULTS

According to the study, people who have smoked more than 17 pack-years had a higher risk to develop pancreatic cancer compared to non-smokers or light smokers (not more than 17 pack-years) (OR 1.98; 95% CI 1.11-3.49, P = 0.017). More importantly, heavy smokers in men had increased risk for developing pancreatic cancer (OR 2.11; 95%CI 1.18-3.78, P = 0.012) than women. Heavy alcohol drinkers (>20 cup-years) had increased risk for pancreatic cancer (OR 3.68; 95%CI 1.60-8.44). Daily diet with high meat intake was also linked to pancreatic cancer. Moreover, 18.5% of the pancreatic cancer patients had diabetes mellitus compared to the control group of 5.8% (P = 0.0003). Typical symptoms of pancreatic cancer were anorexia, upper abdominal pain, bloating, jaundice and weight loss. Each risk factor was assigned a value to represent its importance associated with pancreatic cancer. Subsequently by adding all the points together, a risk scoring model was established with a value higher than 45 as being at risk to develop pancreatic cancer.

CONCLUSION

Smoking, drinking, high meat diet and diabetes are major risk factors for pancreatic cancer. A risk model for pancreatic cancer in Chinese Han population has been established with an 88.9% sensitivity and a 97.6% specificity.

摘要

目的

探讨胰腺癌的危险因素并建立汉族人群的风险模型。

方法

本基于人群的病例对照研究于2002年1月至2004年4月进行。119例胰腺癌患者和238名健康人完成了用于危险因素分析的问卷。采用Logistic回归分析计算比值比(OR)、95%置信区间(Cl)和β值,进而建立风险模型。

结果

根据研究,吸烟超过17包年的人群相较于不吸烟者或轻度吸烟者(不超过17包年)患胰腺癌的风险更高(OR 1.98;95% CI 1.11 - 3.49,P = 0.017)。更重要的是,男性重度吸烟者患胰腺癌的风险增加(OR 2.11;95%CI 1.18 - 3.78,P = 0.012),高于女性。重度饮酒者(>20杯年)患胰腺癌的风险增加(OR 3.68;95%CI 1.60 - 8.44)。日常饮食中肉类摄入量高也与胰腺癌有关。此外,18.5%的胰腺癌患者患有糖尿病,而对照组为5.8%(P = 0.0003)。胰腺癌的典型症状为厌食、上腹痛、腹胀、黄疸和体重减轻。为每个危险因素赋予一个值以代表其与胰腺癌相关的重要性。随后将所有分数相加,建立了一个风险评分模型,得分高于45分即有患胰腺癌的风险。

结论

吸烟、饮酒、高肉类饮食和糖尿病是胰腺癌的主要危险因素。已建立中国汉族人群胰腺癌的风险模型,其灵敏度为88.9%,特异度为97.6%。

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