| 牛建军,苏艳华,韩耀风,赵苒,孙学丽,郭飞,刘胜,赵本华.厦门市不同吸烟类型与其他危险因素致肝癌效应修饰作用[J].Chinese journal of Epidemiology,2010,31(8):850-855 |
| 厦门市不同吸烟类型与其他危险因素致肝癌效应修饰作用 |
| Synergistic effects of different types of smoking and other risk factors on risk of hepatocellular carcinoma in Xiamen, China |
| Received:November 13, 2009 Revised:June 12, 2012 |
| DOI： |
| KeyWord: 吸烟 肝细胞肿瘤 危险因素 |
| English Key Word: Cigarette smoking Hepatocellular carcinoma Risk factors |
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| Abstract: |
| 目的 评价不同类型吸烟暴露的单独效应,并分析吸烟在肝癌发病中的效应修饰作用.方法 采用病例对照研究方法,对345例肝癌病例和961例健康对照进行危险因素调查,采集血液标本进行HBsAg、抗-HCV和黄曲霉毒素(AFB1)白蛋白加合物等含量的检测,针对潜在的危险因素应用多元logistic回归分析评价调整的危险比(AOR)和95%CI.结果 女性被动吸烟暴露与肝癌有关联(AOR=2.35,95%CI:1.19～4.07);男性规律的吸烟与肝癌有关联(AOR=2.27,95%CI:1.14～3.31).在男性,吸烟与慢性乙肝病毒感染有正相关交互作用,交互效应超额相对危险比(RERI)为98.70,归因交互效应百分比(AP)为81.0%(u=2.11,P=0.02);在女性,吸烟与血清AFB1白蛋白加合物浓度有正相关交互作用,交互效应RERI为2.69,归因交互效应AP为50.0%(u=2.60,P=0.01).结论 吸烟与肝癌的关联性有性别差异,尤其是在慢性病毒感染和具有较高浓度的AFB1白蛋白加合物浓度的人群中应控制吸烟. |
| English Abstract: |
| ObjectiveTo evaluated the independent effects of different types of smoking exposure along with multiple risk factors for hepatocellular carcinoma (HCC) and determined whether the magnitude of smoking was modified by other risk factors, both in men and women. Methods We conducted a case-control study in Xiamen China. 345 HCC patients and 961 healthy control subjects were personally interviewed for several HCC risk factors. Multivariate logistic regression analysis was performed to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for each potential risk factor. Results Cigars and pipes were not related to HCC among non-cigarette smokers. However, passive smoking exposure was associated with HCC in women:AOR, 2.35 (95%CI: 1.19-4.07). Regular cigarette smoking was associated with HCC in men: AOR,2.27 (95% CI: 1.14-3.31). Cigarette smoking and chronic infection of hepatitis B virus showed positive additive model interactions in men: RERI(relative excess risk due to interaction) was 98.70and AP (attributable proportion due to interactions) was 81.0%. Data on cigarette smoking with high AFB1-albumin adducts in women showed that the RERI was 2.69 and AP was 50.0%.Conclusion We concluded that sex differences were seen in HCC relationship with cigarette smoking. Controlling of exposure to smoking might be a prudent approach to the prevention of HCC, especially in patients with chronic viral hepatitis infections. |
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