中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2009年
4期
293-298
,共6页
罗翔宇%刘稳升%陈丽珍%冯启胜%曾益新%贾卫华
囉翔宇%劉穩升%陳麗珍%馮啟勝%曾益新%賈衛華
라상우%류은승%진려진%풍계성%증익신%가위화
鼻咽肿瘤%系谱%危险因素
鼻嚥腫瘤%繫譜%危險因素
비인종류%계보%위험인소
Nasopharyngeal neoplasms%Pedigree%Risk factors
目的 研究广东地区家族性鼻咽癌患者与散发性鼻咽癌患者发病因素间存在的差异及其一级亲属恶性肿瘤发病情况,为鼻咽癌患者家庭成员的遗传咨询和筛查策略提供依据.方法 选取2005年10月至2007年10月中山大学肿瘤防治中心收治的广东籍新发鼻咽痛患者作为研究对象,共收集1877例鼻咽痛患者,包括181例家族性鼻咽痛患者和1696例散发病例.对两组患者的人口学特征、临床特征、危险因素及一级亲属肿瘤家族史进行比较分析,并对家族性鼻咽癌患者受累一级亲属的分布及其与先证者发病的时间间隔进行分析.结果 1877例鼻咽癌患者中181例(9.64%)有一级亲属受累;在受累的一级亲属中有58.49%(124/212)为同胞,41.51%(88/212)为父母.同胞与先证者发病的时间间隔为(7.40±5.41)年,而父母与先证者发病的平均时间间隔为(15.55±10.61)年,两者间差异有统计学意义(t=-5.78,P<0.01).两组患者确诊时80%以上临床分期已进入晚期(Ⅲ期以上).无论是患病前还是儿章时期,两组在咸鱼(OR=1.01;95%CI:0.59～1.75 vs OR=1.31;95%CI:0.92～1.86)、腌菜(OR=0.93;95% CI:0.58～1.49 vs OR=1.12;95%CI:0.80～1.57)、酱类(OR=0.37;95%CI:0.14～1.01 vs OR=1.61;95% CI: 0.99～2.48)、新鲜水果(OR=0.87;95%CI: 0.60～1.26 vs OR=0.65;95% CI:0.20～2.12)、腊味(OR=1.26;95%CI:0.87～1.83 vs OR=1.28,95%CI: 0.71～2.30)等饮食因素方面差异均无统计学意义(P值均>0.05).两组患者在吸烟(OR=0.99;95%CI:0.68～1.45)及其一级亲属患其他肿瘤的风险方面(OR=0.85;95%CI:0.56～1.28)差异也无统计学意义(P值均>0.05).结论 在中国广东地区的鼻咽癌患者中,家族性鼻咽癌约占9.64%.在高发家系中,同胞与先证者发病的时间间隔短于父母与先证者发病的时间间隔.大多数患者就诊时已到晚期,建议确诊的鼻咽癌患者的一级亲属,特别是同胞,应根据具体情况定期进行鼻咽癌筛查.
目的 研究廣東地區傢族性鼻嚥癌患者與散髮性鼻嚥癌患者髮病因素間存在的差異及其一級親屬噁性腫瘤髮病情況,為鼻嚥癌患者傢庭成員的遺傳咨詢和篩查策略提供依據.方法 選取2005年10月至2007年10月中山大學腫瘤防治中心收治的廣東籍新髮鼻嚥痛患者作為研究對象,共收集1877例鼻嚥痛患者,包括181例傢族性鼻嚥痛患者和1696例散髮病例.對兩組患者的人口學特徵、臨床特徵、危險因素及一級親屬腫瘤傢族史進行比較分析,併對傢族性鼻嚥癌患者受纍一級親屬的分佈及其與先證者髮病的時間間隔進行分析.結果 1877例鼻嚥癌患者中181例(9.64%)有一級親屬受纍;在受纍的一級親屬中有58.49%(124/212)為同胞,41.51%(88/212)為父母.同胞與先證者髮病的時間間隔為(7.40±5.41)年,而父母與先證者髮病的平均時間間隔為(15.55±10.61)年,兩者間差異有統計學意義(t=-5.78,P<0.01).兩組患者確診時80%以上臨床分期已進入晚期(Ⅲ期以上).無論是患病前還是兒章時期,兩組在鹹魚(OR=1.01;95%CI:0.59～1.75 vs OR=1.31;95%CI:0.92～1.86)、醃菜(OR=0.93;95% CI:0.58～1.49 vs OR=1.12;95%CI:0.80～1.57)、醬類(OR=0.37;95%CI:0.14～1.01 vs OR=1.61;95% CI: 0.99～2.48)、新鮮水果(OR=0.87;95%CI: 0.60～1.26 vs OR=0.65;95% CI:0.20～2.12)、臘味(OR=1.26;95%CI:0.87～1.83 vs OR=1.28,95%CI: 0.71～2.30)等飲食因素方麵差異均無統計學意義(P值均>0.05).兩組患者在吸煙(OR=0.99;95%CI:0.68～1.45)及其一級親屬患其他腫瘤的風險方麵(OR=0.85;95%CI:0.56～1.28)差異也無統計學意義(P值均>0.05).結論 在中國廣東地區的鼻嚥癌患者中,傢族性鼻嚥癌約佔9.64%.在高髮傢繫中,同胞與先證者髮病的時間間隔短于父母與先證者髮病的時間間隔.大多數患者就診時已到晚期,建議確診的鼻嚥癌患者的一級親屬,特彆是同胞,應根據具體情況定期進行鼻嚥癌篩查.
목적 연구엄동지구가족성비인암환자여산발성비인암환자발병인소간존재적차이급기일급친속악성종류발병정황,위비인암환자가정성원적유전자순화사사책략제공의거.방법 선취2005년10월지2007년10월중산대학종류방치중심수치적엄동적신발비인통환자작위연구대상,공수집1877례비인통환자,포괄181례가족성비인통환자화1696례산발병례.대량조환자적인구학특정、림상특정、위험인소급일급친속종류가족사진행비교분석,병대가족성비인암환자수루일급친속적분포급기여선증자발병적시간간격진행분석.결과 1877례비인암환자중181례(9.64%)유일급친속수루;재수루적일급친속중유58.49%(124/212)위동포,41.51%(88/212)위부모.동포여선증자발병적시간간격위(7.40±5.41)년,이부모여선증자발병적평균시간간격위(15.55±10.61)년,량자간차이유통계학의의(t=-5.78,P<0.01).량조환자학진시80%이상림상분기이진입만기(Ⅲ기이상).무론시환병전환시인장시기,량조재함어(OR=1.01;95%CI:0.59～1.75 vs OR=1.31;95%CI:0.92～1.86)、업채(OR=0.93;95% CI:0.58～1.49 vs OR=1.12;95%CI:0.80～1.57)、장류(OR=0.37;95%CI:0.14～1.01 vs OR=1.61;95% CI: 0.99～2.48)、신선수과(OR=0.87;95%CI: 0.60～1.26 vs OR=0.65;95% CI:0.20～2.12)、석미(OR=1.26;95%CI:0.87～1.83 vs OR=1.28,95%CI: 0.71～2.30)등음식인소방면차이균무통계학의의(P치균>0.05).량조환자재흡연(OR=0.99;95%CI:0.68～1.45)급기일급친속환기타종류적풍험방면(OR=0.85;95%CI:0.56～1.28)차이야무통계학의의(P치균>0.05).결론 재중국엄동지구적비인암환자중,가족성비인암약점9.64%.재고발가계중,동포여선증자발병적시간간격단우부모여선증자발병적시간간격.대다수환자취진시이도만기,건의학진적비인암환자적일급친속,특별시동포,응근거구체정황정기진행비인암사사.
Objective To explore the difference between familial and sporadic nasopharyngeal carcinoma patients on risk factors and family history and provide evidence on genetic counseling and screening strategy for relatives of nasopharyngeal carcinoma patients in Guangdong province. Methods The Cantonese nasopharyngeal carcinoma patients diagnosed in Cancer Center, Sun Yat-sen University from October,2005 to October,2007 were recruited as subjects. 1877 patients were collected, including 181 familal nasopharyngeal carcinoma patients and 1696 sporadic nasopharyngeal carcinoma patients. The demographic characteristics, clinical characteristics, risk factors and family history between two groups were compared. Moreover,the distribution of nasopharyngeal carcinoma patients in first-degree relatives and the time interval between proband and the affected first-degree relatives in familial nasopharyngeal carcinoma patients was analyzed. Results All 9.64% of 1877 nasopharyngeal carcinoma patients had affected relatives in first-degree relatives, among them, 58.49% ( 124/212 ) were siblings and 41.51% ( 88/212 ) were parents. The mean time interval between siblings and proband were (7.40±5.41) years while the mean time interval between parents and preband were (15.55±10.61) years when nasopharyngeal carcinoma occurred,and the difference was statistically significant (t=-5.78, P<0.01). More than 80% patients of the two group were at advanced stage when they were diagnosed. There were no difference (P values were all >0.05) beth in adulthood and childhood in salted fish(OR=1.01 ;95% CI: 0.59-1.75 vs OR=1.31; 95% CI:0.92-1.86) ,preserved vegetables (OR=0.93;95% CI:0.58-1.49 vs OR= 1.12;95% CI: 0.80-1.57), fermented pastes (OR=0.37; 95% CI: 0.14-1.01 vs OR=1.61; 95% CI: 0.99-2.48), fresh fruits(OR=0.87;95% CI:0.60-1.26 vs OR=0.65;95%CI:0.20-2.12) and cured meat (OR= 1.26;95 % CI:0.87-1.83 vs OR=1.28;95% CI:0.71 - 2. 30 ) diet. No significant difference (P>0.05) was obtained on smoking (OR=0.99;95% CI:0.68-1.45) and incidence of other cancers in first-degree relatives(OR=0.85; 95% CI: 0.56-1.28) in the two groups. Conclusion Familial nasopharyngeal carcinoma was 9. 64% in the observed subjects. In the familial nasopharyngeal carcinoma, the time interval at diagnosis was shorter between proband and siblings as compared with parents. Most of the patients were at advanced stage. So, we recommend the first-degree relatives of nasopharyngeal carcinoma patients, especially siblings, should be screened regularly according to the specific conditions.
