目的探讨青石棉污染区与肺癌、胸膜间皮瘤相关的饮食偏好及其与青石棉暴露的交互作用。方法对云南省大姚县2011年随访队列发现的53例病例(27例肺癌和26例胸膜间皮瘤)和匹配了性别、年龄的106例对照进行1∶2匹配的病例-对照研究,采用条件Logistic回归方法计算比值比(OR)及其95%CI,并进行单因素和调整混杂因素的多因素数据分析,探索与肺癌、间皮瘤有关的饮食偏好及其保护作用,并进行交互作用分析。结果饮用绿茶(OR=0.88,95%CI 0.66-0.87)、食用野生菌(OR=0.85,95%CI 0.23-0.95)与肺癌、胸膜间皮瘤发生呈负相关,并均减弱青石棉暴露与肺癌、胸膜间皮瘤发生的正性关联。食用野生菌与青石棉暴露存在相加交互作用,超额相对危险因素(RERI)、交互作用归因比(API)和交互作用指数(S)分别为-0.86、-0.26和0.61。结论饮用绿茶和食用野生菌是肺癌、胸膜间皮瘤发生的保护因素。
Objective To understand the relationship between food preference and lung cancer or malignant pleural mesothelioma and the interactive effect between food preference and asbestos exposure in a rural area with naturally occurring asbestos.Methods At the basis of the cohort of Dayao in Yunnan,we performed a 1 ∶ 2 casecontrol study including 53 cases( 23 cases for lung cancer and 26 cases for mesothelioma)and 106 age-and sex-matched normal healthy controls. In order to study the protective effect of food preference and the interactive effect between food preference and asbestos exposure,conditional logistic regression was used to estimate adjusted odds ratios( OR)and their 95% confidence intervals( CI) in both unvaried and multivariate analyses.Result Both green tea and wild mushroom were inversely associated with lung cancer ormalignant pleural mesothelioma,and the adjusted ORs were: 0. 88( 95% CI 0. 66-0. 87) for green tea,0. 85( 95% CI 0. 23- 0. 95) for wild mushroom intake. Food preference to wild mushroom modified the associations of Crocidolite ' s contacting,Respectively,relative excess risk due to interaction( RERI),attributable proportion due to interaction( API),synergy index( S) were 0. 86,0. 26 and 0. 61. Conclusion Both green tea and wild mushroom might serve as protective factors on lung cancer or malignant pleural mesothelioma.