中国食管鳞状细胞癌及其组织学前驱病变的危险因素：一项多中心横断面研究。
Risk factors for esophageal squamous cell carcinoma and its histological precursor lesions in China: a multicenter cross-sectional study.
作者信息
Niu Chen, Liu Yong, Wang Jialin, Liu Yuqin, Zhang Shaokai, Zhang Yongzhen, Zhang Liwei, Zhao Deli, Liu Fugang, Chao Lina, Wang Xinzheng, Zhang Chunli, Song Guohui, Zhang Zhiyi, Li Youpeng, Yan Zheng, Wen Yongxiu, Ge Yinyin, Zang Zhaoping, Feng Wei, Zhang Haiping, Tao Lixin, Nakyeyune Rena, Shen Yi, Shao Yi, Guo Xiuhua, Miles Toni, Yang Aiming, Liu Fen, Wang Guiqi
机构信息
Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China.
Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
出版信息
BMC Cancer. 2021 Sep 16;21(1):1034. doi: 10.1186/s12885-021-08764-x.
BACKGROUND
Despite research efforts, the causative factors that contribute to esophageal squamous cell carcinoma (ESCC) in high-risk areas have not yet been understood. In this study, we, therefore, aimed to describe the risk factors associated with ESCC and its precursor lesions.
METHODS
We performed an endoscopic examination of 44,857 individuals aged 40-69 years from five high incidence regions of China in 2017-2018. Participants were classified as 4 groups of normal control, esophagitis, low-grade intraepithelial neoplasia (LGIN) and high-grade intraepithelial neoplasia/esophageal squamous cell carcinoma (HGIN/ESCC) using an unconditional logistic regression determine risk factors.
RESULTS
We identified 4890 esophagitis, 1874 LGIN and 437 HGIN/ESCC cases. Crude odds ratios (ORs) and adjusted odds ratios were calculated using unconditional logistic regression. Drinking well and surface water, salty diet, and positive family history of cancer were the common risk factors for esophagitis, LGIN and HGIN/ESCC. History of chronic hepatitis/cirrhosis was the greatest risk factor of esophagitis (adjusted OR 2.96, 95%CI 2.52-3.47) and HGIN/ESCC (adjusted OR 1.91, 95%CI 1.03-3.22). Pesticide exposure (adjusted OR 1.20, 95%CI 1.05-1.37) was essential risk factor of LGIN.
CONCLUSIONS
Among individuals aged 40-69 years in high incidence regions of upper gastrointestinal cancer, the results provided important epidemiological evidence for the prevention of different precancerous lesions of ESCC.
背景
尽管进行了研究，但高危地区食管鳞状细胞癌（ESCC）的致病因素仍未明确。因此，在本研究中，我们旨在描述与ESCC及其癌前病变相关的危险因素。
方法
2017年至2018年，我们对来自中国五个高发地区的44857名40 - 69岁个体进行了内镜检查。使用无条件逻辑回归确定危险因素，将参与者分为正常对照、食管炎、低级别上皮内瘤变（LGIN）和高级别上皮内瘤变/食管鳞状细胞癌（HGIN/ESCC）4组。
结果
我们共识别出4890例食管炎、1874例LGIN和437例HGIN/ESCC病例。使用无条件逻辑回归计算粗比值比（OR）和调整后的比值比。饮用井水和地表水、高盐饮食以及癌症家族史阳性是食管炎、LGIN和HGIN/ESCC的常见危险因素。慢性肝炎/肝硬化病史是食管炎（调整后OR 2.96，95%CI 2.52 - 3.47）和HGIN/ESCC（调整后OR 1.91，95%CI 1.03 - 3.22）的最大危险因素。农药暴露（调整后OR 1.20，95%CI 1.05 - 1.37）是LGIN的重要危险因素。
结论
在上消化道癌症高发地区40 - 69岁个体中，本研究结果为预防ESCC不同癌前病变提供了重要的流行病学证据。
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