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目的探索吸烟、饮酒及其交互作用与胃癌发生的关系。方法采用配对病例对照研究,收集了2003年8月~2004年8月303例胃癌新发病例和303例健康对照。对可能的危险因素进行了单因素、调整混杂因素(10年前人均年收入、文化程度、性格、慢性胃部疾病史)的条件lo-gistic回归分析,估计其OR值及95%置信区间。结果调整前后,随着吸烟年数延长、每天吸烟量增大及吸烟包年数增多,胃癌的OR值呈上升趋势(趋势检验,P=0.0214、P=0.0121、P=0.0009)。吸烟年限>30年、每天吸烟量>20支和综合指标吸烟包年数>20者均显示出与胃癌有较强的正关联,其调整后的OR值分别是4.54(95%CI=1.20~17.13)、5.65(95%CI=1.43~22.29)和7.25(95%CI=1.70~30.84);未发现饮酒与胃癌有统计学关联(P=0.242)、未发现调整混杂因素后饮酒与吸烟之间有交互作用,其交互项Waldχ2=0.0276,P>0.05。结论吸烟与胃癌的发病呈正相关;单独饮酒与胃癌发生无明显关系,饮酒并不增加吸烟者患胃癌的风险,两者无协同作用。
Objective To explore the relationship between smoking, drinking and their interaction with gastric carcinogenesis. Methods A matched case-control study was conducted in which 303 new cases of gastric cancer and 303 healthy controls were collected from August 2003 to August 2004. The possible risk factors were assessed by conditional lo-gistic regression analysis with single factor and mixed factors (10 years ago per capita annual income, educational level, personality, chronic gastric disease history), and the OR and 95% confidence intervals were estimated. Results Before and after the adjustment, the OR of gastric cancer showed an upward trend (trend test, P = 0.0214, P = 0.0121, P = 0.0009) as the number of years of smoking increased, the daily amount of cigarettes smoked and the number of years of smoking pack increased. Smoking> 30 years, daily smoking> 20 cigarettes and comprehensive index> 20 years of smoking> all showed a strong positive correlation with gastric cancer. The adjusted OR values were 4.54 (95% CI = 1.20 ~ 17.13 ), 5.65 (95% CI = 1.43-22.29), and 7.25 (95% CI = 1.70-30.84). No association was found between drinking alcohol and gastric cancer (P = 0.242) Interaction, the interaction term Waldχ2 = 0.0276, P> 0.05. Conclusion There was a positive correlation between smoking and the incidence of gastric cancer. There was no significant relationship between alcohol consumption and gastric cancer. Alcohol consumption did not increase the risk of gastric cancer in smokers, and there was no synergistic effect between them.