Guo Xiuchan, Johnson Randall C, Deng Hong, Liao Jian, Guan Li, Nelson George W, Tang Mingzhong, Zheng Yuming, de The Guy, O'Brien Stephen J, Winkler Cheryl A, Zeng Yi
Laboratory of Genomic Diversity, SAIC-Frederick, Inc., NCI-Frederick, Frederick, MD 21702, USA.
Int J Cancer. 2009 Jun 15;124(12):2942-7. doi: 10.1002/ijc.24293.
To understand the role of environmental and genetic influences on nasopharyngeal carcinoma (NPC) in populations at high risk of NPC, we have performed a case-control study in Guangxi Province of Southern China in 2004-2005. NPC cases (n = 1,049) were compared with 785 NPC-free matched controls who were seropositive for IgA antibodies (IgA) to Epstein-Barr virus (EBV) capsid antigen (VCA)-a predictive marker for NPC in Chinese populations. A questionnaire was used to capture exposure and NPC family history data. Risk factors associated with NPC in a multivariant analysis model were the following: (i) a first, second or third degree relative with NPC [attributable risk (AR)= 6%, odds ratio (OR) = 3.1, 95% confidence interval (CI) = 2.0-4.9, p < 0.001]; (ii) consumption of salted fish 3 or more than 3 times per month (AR = 3%, OR = 1.9, 95% CI = 1.1-3.5, p = 0.035); (iii) exposure to domestic wood cooking fires for more than 10 years (AR = 69%, OR = 5.8, 95% CI = 2.5-13.6, p < 0.001); and (iv) exposure to occupational solvents for 10 or less years (AR = 4%, OR = 2.6, 95% CI = 1.4-4.8, p = 0.002). Consumption of preserved meats or a history of tobacco smoking were not associated with NPC (p > 0.05). We also assessed the contribution of EBV/IgA/VCA antibody serostatus to NPC risk-32.2% of NPC can be explained by IgA+ status. However, family history and environmental risk factors cumulatively explained only 2.7% of NPC development in NPC high risk population. These findings should have important public health implications for NPC risk reduction in endemic regions.
为了解环境和遗传因素对鼻咽癌（NPC）高发人群患鼻咽癌的影响，我们于2004年至2005年在中国南方的广西省开展了一项病例对照研究。将1049例鼻咽癌患者与785例无鼻咽癌的匹配对照进行比较，这些对照对爱泼斯坦-巴尔病毒（EBV）衣壳抗原（VCA）的IgA抗体（IgA）呈血清阳性，这是中国人群中鼻咽癌的一个预测标志物。通过问卷调查收集暴露情况和鼻咽癌家族史数据。多变量分析模型中与鼻咽癌相关的危险因素如下：（i）有一级、二级或三级亲属患鼻咽癌[归因风险（AR）=6%，比值比（OR）=3.1，95%置信区间（CI）=2.0-4.9，p<0.001]；（ii）每月食用咸鱼3次或更多（AR=3%，OR=1.9，95%CI=1.1-3.5，p=0.035）；（iii）接触家用木柴烹饪火源超过10年（AR=69%，OR=5.8，95%CI=2.5-13.6，p<0.001）；（iv）接触职业性溶剂10年或更短时间（AR=4%，OR=2.6，95%CI=1.4-4.8，p=0.002）。食用腌制肉类或吸烟史与鼻咽癌无关（p>0.05）。我们还评估了EBV/IgA/VCA抗体血清学状态对鼻咽癌风险的影响——32.2%的鼻咽癌可由IgA阳性状态解释。然而，家族史和环境危险因素累计仅解释了鼻咽癌高危人群中2.7%的鼻咽癌发生情况。这些发现对于流行地区降低鼻咽癌风险应具有重要的公共卫生意义。
