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目的研究有机氯农药二氯二苯三氯乙烷(DDT)和六氯环乙烷(HCH)类雌激素污染物在非职业暴露人群的内暴露水平及与乳腺癌患病风险的关系。方法采用成组病例对照研究方法,调查90名乳腺癌新确诊患者和136名社区健康女性对照。采用问卷调查表收集病例及对照的乳腺癌相关危险因素信息。采用气相色谱-电子捕获(GC-ECD)方法检测血清中有机氯农药残留物水平。运用logistic回归模型分析8种有机氯农药残留物的血清水平与乳腺癌患病风险的相对危险度(OR)。结果病例和对照血清中均能检出p,p’-DDT、p,p’-DDE、o,p’-DDT、p,p’-DDD以及α、β、γ、δ-HCHs有机氯农药残留物,其中β-HCH、p,p’-DDE及p,p’-DDT的总检出率为91·2%、92·1%和91·2%;各物质检出水平在乳腺癌组和对照组间差异无显著性(P>0·05);控制了混杂因素后,p,p’-DDT、p,p’-DDD及δ-HCH暴露与总乳腺癌患病呈正相关(OR>2,P<0·05)。分层分析中绝经前女性的p,p’-DDT、p,p’-DDD、β-HCH血清水平与乳腺癌呈正相关,调整OR分别为3·59、5·70和3·06(P<0·05)。结论有机氯农药残留物(DDTs和HCHs)可能增加妇女,尤其在绝经前妇女患乳腺癌的风险。
Objective To study the relationship between the exposure level of organochlorine pesticides DDT and HCH estrogens in non-occupational exposure population and the risk of breast cancer. Methods A case-control study was conducted in a group of 90 newly diagnosed breast cancer patients and 136 healthy female controls. A questionnaire was used to collect information on breast cancer-related risk factors in both cases and controls. The levels of organochlorine pesticide residues in serum were determined by gas chromatography-electron capture (GC-ECD). The logistic regression model was used to analyze the relative risk (OR) of the serum levels of eight organochlorine pesticide residues and the risk of breast cancer. Results P, p’-DDT, p, p’-DDE, o, p’-DDT, p, p’-DDD and α, β, γ, δ-HCHs organochlorine pesticides were detected in both cases and control sera The total detection rates of β-HCH, p, p’-DDE and p, p’-DDT were 91.2%, 92.1% and 91.2% There was no significant difference between the control group and the control group (P> 0.05). After controlling the confounding factors, there was a positive correlation between the exposure of p, p’-DDT, p, p’-DDD and δ- OR> 2, P <0 · 05). The levels of p, p’-DDT, p, p’-DDD and β-HCH in premenopausal women in stratified analysis were positively correlated with breast cancer, with adjusted ORs of 3.59, 5.70 and 3.06, respectively <0 · 05). Conclusions Organochlorine pesticide residues (DDTs and HCHs) may increase the risk of breast cancer in women, especially in premenopausal women.