食管癌高发区食管炎影响因素的病例对照研究

目的 探讨食管癌高发区肥城市食管炎的影响因素。方法 在肥城市一食管癌高发乡镇40~69岁队列人群中，采用染色内镜和活检病理诊断方法确诊食管炎357例，作为病例组，另选取内镜检查食管黏膜正常者500例作为对照组。分析食管癌家族史、吸烟、饮酒、营养成分等与食管炎的关联，以OR及95%CI作为评价关联强度的指标。结果 将性别、年龄作为调整因素，以无食管癌家族史为比较的基线水平（OR=1.0），一级亲属患食管癌的OR为1.830（95%CI ：1.183~2.833）；以吸烟指数=0为比较的基线水平，吸烟指数≥500的OR为1.852（95%CI ：1.142~3.005）；以饮酒指数=0为比较的基线水平，饮酒指数<130和≥130的OR分别为1.789（95%CI ：1.141~2.804）、1.642（95%CI ：1.029~2.621）；将吸烟（吸烟、不吸烟）、饮酒（饮酒、不饮酒）情况进行组合，以不吸烟+不饮酒为比较的基线水平，吸烟+饮酒的OR为1.889（95%CI ：1.143~3.122）；将各营养成分年摄入量划分为3个层次，以最低水平为比较的基线水平，发现脂肪、叶酸、铁的影响达到显著性水平（OR均小于1）。结论 食管癌家族史、吸烟、饮酒是食管炎的危险因素，营养成分对食管炎的影响不明显。在食管癌高发区，特别是在有食管癌家族史的人群中，提倡戒烟戒酒，对预防食管炎进而减少食管增生和食管癌的发生具有重要的作用。

Case-control study of influencing factors of esophagitis in a high incidence area of esophageal squamous cell cancer

Objective     To investigate the influencing factors of esophagitis in Feicheng City, a high incidence area of esophageal squamous cell cancer (ESCC) of Shandong Province, China. Methods      In a high incidence community of ESCC, a cohort of residents aged from 40 to 69 were examined for esophageal lesions. The case group included 357 cases of esophagitis diagnosed by staining endoscope and pathogenic examination, and 500 persons with normal esophageal mucosa determined by gastric endoscope served as the control group. The associations of family history of esophageal cancer, smoking, drinking and nutrition ingredients with esophagitis were analyzed, and OR and 95%CI were used as the association indicators. Results      Gender and age were regarded as adjusting factors. When no family history of  esophageal cancer was used as the base line, the OR was 1.830 （95%CI：1.183 2.833） for those whose first-graderelatives had suffered from esophageal cancer; when smoking index=0 was used as the base line, the OR was 1.852 （95%CI ：1.142 3.005） for smoking index≥500; when drinking index=0 was used as the base line,the OR was 1.789（95%CI ：1.141 2.804） and 1.642（95%CI：1.029 2.621）for drinking index <130 and ≥130 respectively; when no-smoking and no-drinking was used as the base line, the OR was 1.889（95%CI ：1.143 3.122） for both smoking and drinking； the annual intake of nutrition ingredients was classified into three levels, and when the lowest level was used as the base line, the ORs for fat, folic acid and iron reached significant levels. Conclusion      Family history of esophageal cancer, smoking and drinking are risk factors, but nutrition ingredients do not play obvious role for esophagitis. Abstinence from smoking and drinking is important to prevent esophagitis, and then reduce esophageal dysplasia and cancer in high incidence areas of esophageal cancer especially in those who have family history of esophageal cancer.