利用胰腺癌的危险因素及其在癌症筛查中的相互作用：中国上海的一项病例对照研究。
Using the Risk Factors of Pancreatic Cancer and Their Interactions in Cancer Screening: A Case-Control Study in Shanghai, China.
机构信息
Department of Pediatrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, CN.
School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, CN.
出版信息
Ann Glob Health. 2019 Jul 11;85(1):103. doi: 10.5334/aogh.2463.
BACKGROUND
The incidence of pancreatic cancer has increased annually, but the risk factors and their interactions are still unknown.
OBJECTIVE
The aim of this study was to identify risk factors and the effects of their interactions on pancreatic cancer occurrence among patients in Shanghai, China.
METHODS
We conducted a hospital-based case-control study. The case group consisted of pathologically diagnosed pancreatic cancer patients, and the control group consisted of a healthy population. The Pearson Chi-square test was used to compare the distribution frequencies of data between groups. Multivariate analysis and interaction analysis were conducted to explore possible risk factors and interactions between various variables.
FINDINGS
Among the 4,821 recruited participants, 1,392 were pancreatic cancer patients and 3,429 were controls. Multivariate logistic analysis suggested that age (>50 years old) (AOR: 16.20 [95% CI 6.78; 38.69]), diabetes (AOR: 5.40 [95% CI 2.70; 10.80]), chronic pancreatitis (AOR: 27.43 [95% CI 2.14; 351.77]), smoking (AOR: 8.86 [95% CI 3.07; 25.58]), and family cancer history (AOR: 2.10 [95% CI 1.09; 8.56]) were the primary risk factors for pancreatic cancer. Interestingly, synergistic interactions between risk factors were found, especially between age and chronic pancreatitis (RERI = 447.93, API = 96.74%, SI = 32.78), age and smoking (RERI = 187.42, API = 94.97%, SI = 21.99), and diabetes and smoking (RERI = 14.39, API = 48.06%, SI = 1.99).
CONCLUSIONS
Age, diabetes, chronic pancreatitis, smoking, and family cancer history have been verified as the primary risk factors for pancreatic cancer in this study. Moreover, the interaction effects between old age, diabetes, chronic pancreatitis, and smoking substantially increase the probability of the development of pancreatic cancer. Cancer screening should be conducted extensively among people with these multiple factors to improve the efficiency.
背景
胰腺癌的发病率逐年上升，但风险因素及其相互作用仍不清楚。
目的
本研究旨在确定中国上海人群中胰腺癌发生的风险因素及其相互作用。
方法
我们进行了一项基于医院的病例对照研究。病例组为经病理诊断为胰腺癌的患者，对照组为健康人群。采用 Pearson 卡方检验比较组间数据的分布频率。采用多变量分析和交互作用分析探讨可能的风险因素及各变量间的交互作用。
结果
在招募的 4821 名参与者中，1392 名为胰腺癌患者，3429 名为对照。多变量 logistic 分析提示年龄（>50 岁）（OR：16.20 [95% CI 6.78；38.69]）、糖尿病（OR：5.40 [95% CI 2.70；10.80]）、慢性胰腺炎（OR：27.43 [95% CI 2.14；351.77]）、吸烟（OR：8.86 [95% CI 3.07；25.58]）和家族癌症史（OR：2.10 [95% CI 1.09；8.56]）是胰腺癌的主要危险因素。有趣的是，还发现了危险因素之间的协同交互作用，尤其是年龄和慢性胰腺炎（RERI = 447.93，API = 96.74%，SI = 32.78）、年龄和吸烟（RERI = 187.42，API = 94.97%，SI = 21.99）以及糖尿病和吸烟（RERI = 14.39，API = 48.06%，SI = 1.99）之间。
结论
年龄、糖尿病、慢性胰腺炎、吸烟和家族癌症史已被证实为本研究中胰腺癌的主要危险因素。此外，高龄、糖尿病、慢性胰腺炎和吸烟之间的相互作用显著增加了胰腺癌发生的概率。应广泛开展针对这些多种因素人群的癌症筛查，以提高效率。
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