CAJ | 학술논문

目的评价不同类型吸烟暴露的单独效应,并分析吸烟在肝癌发病中的效应修饰作用.方法采用病例对照研究方法,对345例肝癌病例和961例健康对照进行危险因素调查,采集血液标本进行HBsAg、抗-HCV和黄曲霉毒素(AFB1)白蛋白加合物等含量的检测,针对潜在的危险因素应用多元logistic回归分析评价调整的危险比(AOR)和95%CI.结果女性被动吸烟暴露与肝癌有关联(AOR=2.35,95%CI:1.19～4.07);男性规律的吸烟与肝癌有关联(AOR=2.27,95%CI:1.14～3.31).在男性,吸烟与慢性乙肝病毒感染有正相关交互作用,交互效应超额相对危险比(RERI)为98.70,归因交互效应百分比(AP)为81.0%(u=2.11,P=0.02);在女性,吸烟与血清AFB1白蛋白加合物浓度有正相关交互作用,交互效应RERI为2.69,归因交互效应AP为50.0%(u=2.60,P=0.01).结论吸烟与肝癌的关联性有性别差异,尤其是在慢性病毒感染和具有较高浓度的AFB1白蛋白加合物浓度的人群中应控制吸烟.
목적 평개불동류형흡연폭로적단독효응,병분석흡연재간암발병중적효응수식작용.방법 채용병례대조연구방법,대345례간암병례화961례건강대조진행위험인소조사,채집혈액표본진행HBsAg、항-HCV화황곡매독소(AFB1)백단백가합물등함량적검측,침대잠재적위험인소응용다원logistic회귀분석평개조정적위험비(AOR)화95%CI.결과 녀성피동흡연폭로여간암유관련(AOR=2.35,95%CI:1.19～4.07);남성규률적흡연여간암유관련(AOR=2.27,95%CI:1.14～3.31).재남성,흡연여만성을간병독감염유정상관교호작용,교호효응초액상대위험비(RERI)위98.70,귀인교호효응백분비(AP)위81.0%(u=2.11,P=0.02);재녀성,흡연여혈청AFB1백단백가합물농도유정상관교호작용,교호효응RERI위2.69,귀인교호효응AP위50.0%(u=2.60,P=0.01).결론 흡연여간암적관련성유성별차이,우기시재만성병독감염화구유교고농도적AFB1백단백가합물농도적인군중응공제흡연.
Objective To evaluated the independent effects of different types of smoking exposure along with multiple risk factors for hepatocellular carcinoma (HCC) and determined whether the magnitude of smoking was modified by other risk factors, both in men and women.Methods We conducted a case-control study in Xiamen China. 345 HCC patients and 961 healthy control subjects were personally interviewed for several HCC risk factors. Multivariate logistic regression analysis was performed to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for each potential risk factor. Results Cigars and pipes were not related to HCC among non-cigarette smokers. However, passive smoking exposure was associated with HCC in women:AOR, 2.35 (95%CI: 1.19-4.07). Regular cigarette smoking was associated with HCC in men: AOR,2.27 (95% CI: 1.14-3.31). Cigarette smoking and chronic infection of hepatitis B virus showed positive additive model interactions in men: RERI(relative excess risk due to interaction) was 98.70and AP (attributable proportion due to interactions) was 81.0%. Data on cigarette smoking with high AFB1-albumin adducts in women showed that the RERI was 2.69 and AP was 50.0%. Conclusion We concluded that sex differences were seen in HCC relationship with cigarette smoking. Controlling of exposure to smoking might be a prudent approach to the prevention of HCC, especially in patients with chronic viral hepatitis infections.