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中国东北沈阳地区不吸烟女性的非恶性呼吸系统疾病与肺癌风险。

Risk of lung cancer following nonmalignant respiratory conditions among nonsmoking women living in Shenyang, Northeast China.

机构信息

Department of Epidemiology, School of Public Health, China Medical University, Shenyang, PR China.

出版信息

J Womens Health (Larchmt). 2009 Dec;18(12):1989-95. doi: 10.1089/jwh.2008.1355.

Abstract

BACKGROUND

There has been conflicting evidence about possible associations between nonmalignant respiratory conditions (NMRCs) and subsequent risk of lung cancer. Determination of whether or not there is such an association has potential importance for managing NMRCs, for screening of lung cancer, and for understanding mechanisms of carcinogenesis.

METHODS

A hospital-based, case-control study involving interviews with 226 female nonsmoking lung cancer patients and 279 matching population controls was conducted in Shenyang, Northeast China, between January 2004 and December 2007. A standardized interview collected information on a variety of potential risk factors, including a history of physician-diagnosed NMRCs (pulmonary tuberculosis, chronic bronchitis, emphysema, asthma, and bronchiectasis), and age/year in which each condition was first diagnosed. Multivariate logistic regression analyses were applied to assess the associations between NMRCs and subsequent lung cancer risk.

RESULTS

Compared with those without, subjects with a history of NMRC experience greater risk of lung cancer (OR=2.0, 95% CI 1.2-3.4), particularly following a diagnosis of pulmonary tuberculosis (OR=4.7, 95% CI 1.6-13.2). The results from subgroup analysis, when limited to small cell lung cancer, showed a 6.2-fold increase in lung cancer risk among asthmatics (95% CI 1.5-25.8). However, there was no evidence of a significant association between chronic bronchitis and lung cancer.

CONCLUSIONS

This study strengthens the evidence linking NMRCs, especially pulmonary tuberculosis, to lung cancer even in lifelong nonsmoking women.

摘要

背景

非恶性呼吸系统疾病(NMRCs)与随后的肺癌风险之间可能存在关联,这方面的证据相互矛盾。确定是否存在这种关联对于管理 NMRCs、肺癌筛查以及理解致癌机制具有潜在重要性。

方法

2004 年 1 月至 2007 年 12 月期间,在中国东北沈阳进行了一项基于医院的病例对照研究,涉及对 226 名女性不吸烟肺癌患者和 279 名匹配人群对照进行访谈。标准化访谈收集了各种潜在风险因素的信息,包括曾被医生诊断为 NMRC(肺结核、慢性支气管炎、肺气肿、哮喘和支气管扩张)的病史,以及每种疾病首次诊断的年龄/年份。多变量逻辑回归分析用于评估 NMRCs 与随后肺癌风险之间的关联。

结果

与没有 NMRC 病史的人相比,有 NMRC 病史的人患肺癌的风险更高(OR=2.0,95%CI 1.2-3.4),尤其是在诊断为肺结核后(OR=4.7,95%CI 1.6-13.2)。当限于小细胞肺癌进行亚组分析时,哮喘患者的肺癌风险增加了 6.2 倍(95%CI 1.5-25.8)。然而,慢性支气管炎与肺癌之间没有明显的关联。

结论

本研究加强了 NMRCs,特别是肺结核与肺癌之间的关联证据,即使在终身不吸烟的女性中也是如此。

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