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[目的]通过病例对照研究,探讨仙游县胃癌发病的危险因素及其存在的交互作用。[方法]选取2013年5月—2015年6月期间经病理确诊并在仙游县生活达10年或以上的胃癌病例433例,选取866位健康人作为对照进行1∶2个体匹配,进行面对面问卷调查。构建分类回归树发现存在交互作用的因素并应用条件logistic回归分析各因素可能存在的相乘交互作用。[结果]多因素条件logistic回归分析结果显示:饮食速度快(OR=1.321,95%CI:1.055~1.653)、食物较硬(OR=1.709,95%CI:1.344~2.174)、食用腌菜(OR=1.359,95%CI:1.083~1.704)、吸烟(OR=1.875,95%CI:1.261~2.786)、慢性萎缩性胃炎(OR=2.395,95%CI:1.228~4.672)、肿瘤家族史(OR=1.545,95%CI:1.061~2.250)、接触农药(OR=2.840,95%CI:2.003~4.025)及对家庭现状不满意(OR=2.383,95%CI:1.708~3.326)为仙游县胃癌发病的主要危险因素;而食用新鲜蔬菜(OR=0.653,95%CI:0.485~0.878)、食用菌(OR=0.657,95%CI:0.494~0.872)、海带(OR=0.671,95%CI:0.500~0.901)及洋葱大葱(OR=0.638,95%CI:0.518~0.787)为其保护因素。交互作用结果显示:接触农药和食用腌菜、食物硬,食用腌菜和饮食速度快、吸烟之间存在相乘交互作用。[结论]接触农药、食用腌菜、食物硬、饮食速度快及吸烟在仙游县胃癌发生、发展中存在交互作用。
[Objective] To explore the risk factors of gastric cancer and its interaction in Xianyou County through case-control study. [Methods] A total of 433 cases of gastric cancer diagnosed by pathology and living in Xianyou County for 10 years or more were selected from May 2013 to June 2015. 866 healthy volunteers were selected as the control to carry out 1: 2 individual matching and face to face Questionnaire. Construction of classification regression tree to find the existence of interaction factors and the application of conditional logistic regression analysis of the factors that may exist in the multiplication interaction. [Results] The results of multivariate conditional logistic regression analysis showed that the diet fast (OR = 1.321, 95% CI: 1.055-1.653), the food was harder (OR = 1.709, 95% CI: 1.344-2.174) (OR = 1.359, 95% CI: 1.083-1.704), smoking (OR = 1.875,95% CI: 1.261-2.786), chronic atrophic gastritis (OR = 2.395,95% CI: 1.228-4.672) OR = 1.545, 95% CI: 1.061 ~ 2.250), contact with pesticides (OR = 2.840,95% CI: 2.003-4.025) and dissatisfaction with family status (OR = 2.383, 95% CI: 1.708-3.326) (OR = 0.653, 95% CI: 0.485-0.878), edible fungus (OR = 0.657, 95% CI: 0.494-0.872), seaweed (OR = 0.671, 95% CI: 0.500 ~ 0.901) and onions (OR = 0.638, 95% CI: 0.518 ~ 0.787) were the protective factors. Interaction results show that there is a multiplicative interaction between exposure to pesticides and food pickles, food hardness, food pickles and fast food intake and smoking. [Conclusion] There was interaction between pesticide exposure, food pickles, food hardness, fast food intake and smoking in the occurrence and development of stomach cancer in Xianyou County.