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目的 探讨间皮瘤发病的影响因素 ,以期为间皮瘤的预防及进一步研究发病机制提供流行病学依据。方法 采用 1∶1配比的病例 -对照设计调查了 2 3例间皮瘤病例和对照 ,比较两组间的石棉接触情况、生活方式及一级亲属恶性肿瘤发病情况。结果 病例组平均年龄 5 7.96岁 ,间皮瘤平均潜伏期为 5 2年 ,与对照组相比 ,其石棉接触年龄、接触时间以及吸烟、饮酒习惯的差异均无显著性 (P >0 .0 5 ) ;病例组平均累积石棉纤维接触剂量为 37.2× 10 5f,明显高于对照组 (32 .3× 10 5f) ,差异有显著性 (P =0 .0 0 5 ) ,且随剂量的增高 ,OR值有升高趋势。病例组一级亲属患恶性肿瘤的比例(2 6 .1%)高于对照组 (4 .4%) ,差异有显著性 (P <0 .0 5 ) ,OR =7.75 (95 %CI:0 .85～ 71.43)。结论 石棉接触与间皮瘤发病间可能存在剂量 -效应关系 ;癌家族史可能是间皮瘤的一个危险因素 ,或者在相同的石棉接触水平下可增加个体对间皮瘤的易感性。
Objective To investigate the influencing factors of mesothelioma in order to provide epidemiological evidence for the prevention and further study of the pathogenesis of mesothelioma. Methods Twenty-three cases of mesothelioma and controls were investigated by a 1: 1 matched case-control design. The incidence of asbestos exposure, life style and the incidence of first-degree malignant tumors were compared between the two groups. Results The average age of cases was 5 7.96 years old and the average incubation period of mesothelioma was 52 years. There was no significant difference in the contact age, contact time, smoking and drinking habit of asbestos between the two groups (P> 0.05) ). The average accumulated asbestos fiber contact dose in the case group was 37.2 × 10 5f, which was significantly higher than that in the control group (32.3 × 10 5f) (P = 0.05). With the increase of the dose, OR value has a rising trend. The proportion of first-degree relatives in the case group with malignant tumors was significantly higher than that of the control group (4.6%) (P <0.05), OR = 7.75 (95% CI: 0 .85 ~ 71.43). Conclusions There may be a dose-response relationship between asbestos exposure and mesothelioma. Carcinoma family history may be a risk factor for mesothelioma, or increase individual susceptibility to mesothelioma with the same level of asbestos exposure.