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中国女性乳腺癌发病相关危险因素:病例对照研究

徐雅莉,  孙强,  单广良,  张瑾,  廖海波,  李世拥,  姜军,  邵志敏,  蒋宏传,  沈念春,  石岳,  尉承泽,  张保宁,  陈妍华,  段学宁,  李波

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文章导航 > 协和医学杂志  > 2011 >  2(1): 7-14
徐雅莉, 孙强, 单广良, 张瑾, 廖海波, 李世拥, 姜军, 邵志敏, 蒋宏传, 沈念春, 石岳, 尉承泽, 张保宁, 陈妍华, 段学宁, 李波. 中国女性乳腺癌发病相关危险因素:病例对照研究[J]. 协和医学杂志, 2011, 2(1): 7-14. doi: 10.3969/j.issn.1674-9081.2011.01.002
引用本文: 徐雅莉, 孙强, 单广良, 张瑾, 廖海波, 李世拥, 姜军, 邵志敏, 蒋宏传, 沈念春, 石岳, 尉承泽, 张保宁, 陈妍华, 段学宁, 李波. 中国女性乳腺癌发病相关危险因素:病例对照研究[J]. 协和医学杂志, 2011, 2(1): 7-14. doi: 10.3969/j.issn.1674-9081.2011.01.002
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Ya-li XU, Qiang SUN, Guang-liang SHAN, Jin Zhang, Hai-bo Liao, Shi-yong Li, Jun JIANG, Zhi-min Shao, Hong-chuan JIANG, Nian-chun SHEN, Yue SHI, Cheng-ze YU, Bao-ning ZHANG, Yan-hua CHEN, Xue-ning DUAN, Bo LI. Risk Factors of Breast Cancer in China: A Case-Control Study[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(1): 7-14. doi: 10.3969/j.issn.1674-9081.2011.01.002
Citation: Ya-li XU, Qiang SUN, Guang-liang SHAN, Jin Zhang, Hai-bo Liao, Shi-yong Li, Jun JIANG, Zhi-min Shao, Hong-chuan JIANG, Nian-chun SHEN, Yue SHI, Cheng-ze YU, Bao-ning ZHANG, Yan-hua CHEN, Xue-ning DUAN, Bo LI. Risk Factors of Breast Cancer in China: A Case-Control Study[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(1): 7-14. doi: 10.3969/j.issn.1674-9081.2011.01.002
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中国女性乳腺癌发病相关危险因素:病例对照研究

doi: 10.3969/j.issn.1674-9081.2011.01.002
  • 1.

    中国医学科学院 北京协和医学院 北京协和医院乳腺外科, 北京 100730

  • 2.

    中国医学科学院 北京协和医学院 基础医学研究所流行病学与统计学教研室, 北京 100730

  • 3.

    天津医科大学 附属肿瘤医院乳腺肿瘤三科, 天津 300060

  • 4.

    盐城迎宾外科医院乳腺疾病治疗中心, 江苏盐城 224005

  • 5.

    中国人民解放军 北京军区总医院普通外科, 北京 100700

  • 6.

    第三军医大学 第一附属医院(西南医院)乳腺外科, 重庆 400038

  • 7.

    复旦大学 附属肿瘤医院乳腺外科, 上海 200032

  • 8.

    首都医科大学 附属北京朝阳医院普通外科, 北京 100020

  • 9.

    珠海市计划生育服务中心, 广东珠海 519100

  • 10.

    山西省中医药研究院乳腺科, 太原 030012

  • 11.

    军事医学科学院 附属医院(307医院)普通外科, 北京 100071

  • 12.

    中国医学科学院 北京协和医学院 肿瘤医院腹部外科, 北京 100021

  • 13.

    秦皇岛市妇幼保健院乳腺科, 河北秦皇岛 066000

  • 14.

    北京大学 第一医院普通外科, 北京 100034

  • 15.

    卫生部 北京医院普通外科, 北京 100730

基金项目: 

“十一五”国家科技支撑计划项目 2006BAI02A09

详细信息
    通讯作者:

    孙强 电话:010-88068140, E-mail:pumchsunqiang@126.com

  • 中图分类号: R737.9;R181.3+2;R181.2+3

Risk Factors of Breast Cancer in China: A Case-Control Study

  • 1.

    Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100005, China

  • 3.

    The 3rd Department of Breast Neoplasm, Cancer Hospital, Tianjin Medical University, Tianjin 300060, China

  • 4.

    Treatment Center of Breast Disease, Yingbin Surgery Hospital, Yancheng 224005, China

  • 5.

    Department of General Surgery, General Hospital affiliated to Beijing Military Area Command, Beijing 100700, China

  • 6.

    Department of Breast Surgery, Affiliated Southwest Hospital, Third Military Medical University, Chongqing 400038, China

  • 7.

    Department of Breast Surgery, Affiliated Cancer Hospital, Fudan University, Shanghai 200032, China

  • 8.

    Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

  • 9.

    Population and Family Planning Service Center of Zhuhai, Zhuhai 519100, China

  • 10.

    Department of Breast Disease, Shanxi Traditional Medicine Hospital, Taiyuan 030012, China

  • 11.

    Department of General Surgery, Chinese 307 Hospital affiliated to the People's Liberation Army, Beijing 100071, China

  • 12.

    Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China

  • 13.

    Department of Breast Disease, Maternity & Child Care Center of Qinhuangdao, Qinhuangdao 066000, China

  • 14.

    Department of General Surgery, First Hospital, Peking University, Beijing 100034, China

  • 15.

    Department of General Surgery, Beijing Hospital, Ministry of Health, Beijing 100730, China

More Information

    摘要
  • 摘要:   目的  筛查中国女性乳腺癌发病相关危险因素, 为个体化评估中国女性乳腺癌发病危险性提供依据。  方法  在全国8个省市14家研究中心开展1:m配对病例对照研究, 采用调查问卷通过面对面交流收集乳腺癌发病相关危险因素信息。乳腺癌患者及其配对健康对照女性年龄、生活环境相匹配。应用1:m条件Logistic回归分析乳腺癌相关危险因素在病例组和对照组间的分布特点, 明确其与乳腺癌发病危险性的相关性。  结果  共纳入416例乳腺癌患者及1156例健康对照女性。中国女性乳腺癌发病相关危险因素包括体重指数(body mass index, BMI)≥24(OR=4.07, 95% CI:2.98~5.55), 乳腺良性病变活检史(OR=1.68, 95% CI:1.19~2.38), 初潮年龄≥14岁(OR=1.41, 95% CI:1.07~1.87), 生存压力大(1~4级, OR=2.15, 95% CI:1.26~3.66;5~9级, OR=3.48, 95% CI:2.03~5.95), 绝经(OR=2.22, 95% CI:1.50~3.28)(P < 0.05), 乳腺癌家族史(OR=1.72, 95% CI:1.15~2.58), 肿瘤家族史(乳腺癌除外)(OR=1.55, 95% CI:1.22~1.98)。口服避孕药(OR=1.59, 95% CI:0.83~3.05)亦增加乳腺癌发病危险性, 但差异未达到显著统计学意义(P>0.05)。  结论  中国女性乳腺癌发病相关危险因素包括BMI≥24、乳腺良性病变活检史、初潮年龄≥14岁、生存压力大、绝经、乳腺癌家族史及其他肿瘤家族史。本研究为个体化评估中国女性罹患乳腺癌危险性及广泛开展乳腺癌防治工作提供了依据。
    Abstract:   Objective  To screen the risk factors associated with breast cancer among Chinese women, with an attempt to provide evidence for the evaluation of breast cancer risks among Chinese women on an individual level.  Methods  A case-control study on 416 breast cancer patients and 1156 age-and region-matched controls was conducted in 14 hospitals in 8 provinces/municipalities of China.Conditional logistic regression was applied to analyze the association between risk factors and breast cancer.  Results  The risk factors of breast cancer among Chinese women included higher body mass index(BMI ≥ 24)(OR=4.07, 95%CI:2.98-5.55), history of benign breast disease biopsy(OR=1.68, 95%CI:1.19-2.38), age of menarche ≥ 14 years(OR=1.41, 95%CI:1.07-1.87), psychological depression(for grade 1-4, OR=2.15, 95% CI:1.26-3.66;for grade 5-9, OR=3.48, 95% CI:2.03-5.95), menostasia(OR=2.22, 95% CI:1.50-3.28), family history of breast cancer(OR=1.72, 95%CI:1.15-2.58), and family history of cancer other than breast cancer(OR=1.55, 95%CI:1.22~1.98)(all P < 0.05 when compared between the 416 breast cancer patients and 1156 controls).Although use of oral contraceptives(OC)(OR=1.59, 95% CI:0.83-3.05)was associated with an increased risk of breast cancer, the difference was not statistically significant(P > 0.05).  Conclusions  Many risk factors including BMI ≥ 24, history of benign breast disease biopsy, age of menarche ≥ 14 years, psychological depression, menostasia, family history of breast cancer, and family history of cancer other than breast cancer may contribute to breast cancer among Chinese women.This research provides a basis for the individualized evaluation of risks of breast cancer and the population-based interventions in China.
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  • 表  1  病例组与对照组基线特征及乳腺癌危险因素对比表

    表  2  条件配对多元Logistic回归分析乳腺癌危险因素
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