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目的:探讨磁县食管癌(含贲门癌)家庭聚集性及遗传因素在磁县食管癌病因中的作用,计算食管癌分离比及一级亲属遗传度。方法:采用病例-对照研究的方法,逐例入户调查了285例食管癌的新发病例及1415例对照者的一级亲属食管癌患病及家族史等情况,比较其食管癌的患病率。用二项分布拟合优度χ~2检验食管癌家庭聚集性;单病例法(Li-Mantel-Gart)计算分离比;Falconer法计算遗传度。结果:食管癌先证者一级亲属发生率(12.80%),高于对照者一级亲属发生率(7.52%),差异有统计学意义(χ~2=44.34,P=0.000)。食管癌在家族中分布不符合二项分布,呈现明显的家族聚集性(χ~2=288.19,P<0.0001)。食管癌遗传度为(29.67±4.32)%,分离比0.181(95%CI:0.157～0.205),可认为属于多基因遗传病。结论:磁县食管癌是遗传因素和环境因素共同作用的结果,食管癌家族史增加食管癌发病风险。
Objective: To investigate the role of familial aggregation and genetic factors of esophageal cancer (including cardia cancer) in esophageal cancer in Ci County and to calculate the esophageal cancer isolates and the heritability of first-degree relatives. Methods: A case-control study was conducted to investigate the incidence of esophageal cancer in 285 newly diagnosed cases of esophageal cancer and the first-degree relatives of esophageal cancer in 1415 controls. rate. The binomial distribution goodness of fit χ ~ 2 was used to test the family aggregation of esophageal cancer. The Li-Mantel-Gart was used to calculate the segregation ratio. The Falconer method was used to calculate the heritability. Results: The incidence of first-degree relatives of esophageal cancer probands (12.80%) was higher than that of first-degree relatives of control subjects (7.52%). There was significant difference between them (χ ~ 2 = 44.34, P = 0.000). The distribution of esophageal cancer in the family does not meet the binomial distribution, showing significant familial aggregation (χ ~ 2 = 288.19, P <0.0001). The heritability of esophageal cancer was (29.67 ± 4.32)%, with the isolation ratio of 0.181 (95% CI: 0.157 ~ 0.205), which could be considered as polygenic inheritance. Conclusion: Esophageal cancer in Cixian County is the result of interaction between genetic factors and environmental factors. Esophageal cancer family history may increase the risk of esophageal cancer.