Kubo Ai, Levin T R, Block Gladys, Rumore Gregory, Quesenberry Charles P, Buffler Patricia, Corley Douglas A
Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
Cancer Causes Control. 2009 Apr;20(3):303-11. doi: 10.1007/s10552-008-9244-4. Epub 2008 Oct 14.
We examined the association between smoking and the risk of Barrett's esophagus (BE), a metaplastic precursor to esophageal adenocarcinoma.
We conducted a case-control study within the Kaiser Permanente Northern California population. Patients with a new diagnosis of BE (n = 320) were matched to persons with gastroesophageal reflux disease (GERD) (n = 316) and to population controls (n = 317). Information was collected using validated questionnaires from direct in-person interviews and electronic databases. Analyses used multivariate unconditional logistic regression that controlled for age, gender, race, and education.
Ever smoking status, smoking intensity (pack-years), and smoking cessation were not associated with the risk of BE. Stratified analyses suggested that ever smoking may be associated with an increased risk of BE among some groups (compared to population controls): persons with long-segment Barrett's esophagus (odds ratio [OR] = 1.72, 95% confidence interval [CI] 1.12-2.63); subjects without GERD symptoms (OR = 3.98, 95% CI 1.58-10.0); obese subjects (OR = 3.38, 95% CI 1.46-7.82); and persons with a large abdominal circumference (OR = 3.02, 95% CI (1.18-2.75)).
Smoking was not a strong or consistent risk factor for BE in a large community-based study, although associations may be present in some population subgroups.
我们研究了吸烟与巴雷特食管（BE）风险之间的关联，BE是食管腺癌的一种化生前体。
我们在北加利福尼亚凯撒医疗集团人群中开展了一项病例对照研究。新诊断为BE的患者（n = 320）与胃食管反流病（GERD）患者（n = 316）及人群对照（n = 317）进行匹配。通过直接面对面访谈的有效问卷和电子数据库收集信息。分析采用多变量无条件逻辑回归，对年龄、性别、种族和教育程度进行了控制。
曾经吸烟状态、吸烟强度（包年数）和戒烟与BE风险无关。分层分析表明，在某些组中（与人群对照相比），曾经吸烟可能与BE风险增加有关：长段巴雷特食管患者（比值比[OR]=1.72，95%置信区间[CI]1.12 - 2.63）；无GERD症状的受试者（OR = 3.98，95%CI 1.58 - 10.0）；肥胖受试者（OR = 3.38，95%CI 1.46 - 7.82）；以及腹围较大的人（OR = 3.02，95%CI（1.18 - 2.75））。
在一项基于大型社区的研究中，吸烟并非BE的强烈或一致风险因素，尽管在某些人群亚组中可能存在关联。
