肺癌危險因素的Meta分析_《中國循證醫學雜志》

作者：

王冬梅 ¹ , 陳勃江 ¹ ,  李為民 ¹ , 李靜 ² , 陳文彬 ¹

1. 四川大學華西醫院呼吸內科（成都 610041）；2. 四川大學華西醫院中國循證醫學中心（成都 610041）;

關鍵詞：

肺癌危險因素 Meta分析比值比

DOI：

10.7507/1672-2531.20100610

視頻：

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目的　探討人群肺癌發生的危險因素，為制定肺癌的預防控制措施提供科學依據。
方法　計算機檢索MEDLINE、CNKI和CBM，并輔以手工檢索、文獻追溯等方法，收集國內外1997年1月～2007年1月公開發表的關于人群肺癌發病危險因素的研究文獻，采用RevMan 4.2軟件進行Meta分析。
結果　共納入40篇文獻，累計病例16 559例，對照25 119例。各因素合并比值比（OR）分別為：吸煙（5.75）、女性被動吸煙（來源于丈夫）（1.32）、女性被動吸煙（來源于同事）（1.21）、慢支炎（1.68）、肺氣腫（2.70）、肺結核（1.58）、腫瘤家族史（1.24）、肺癌家族史（1.59）。吸煙、女性被動吸煙（來源于丈夫）、女性被動吸煙（來源于同事）、慢支炎、肺氣腫、肺結核、腫瘤家族史、肺癌家族史和石棉暴露對肺癌的人群歸因危險度百分比分別為69.16%、14.52%、5.87%、7.45%、10.18%、1.91%、8.92%、5.33%和7.37%。
結論　目前影響人群肺癌發生的危險因素為吸煙、女性被動吸煙（來源于丈夫）、女性被動吸煙（來源于同事）、慢支炎、肺氣腫、肺結核、腫瘤家族史和肺癌家族史等。人群歸因危險度百分比的計算表明，吸煙最高，其次是女性被動吸煙（來源于丈夫），再次是肺氣腫和腫瘤家族史等，提示環境因素和遺傳因素在人群肺癌發病中均具有重要作用。

引用本文： 王冬梅,陳勃江,李為民,李靜,陳文彬. 肺癌危險因素的Meta分析. 中國循證醫學雜志, 2010, 10(12): 1446-1459. doi: 10.7507/1672-2531.20100610 復制

1.	Pirozynski M. 100 years of lung cancer. Respir Med, 2006, 100(12): 2073-2084.
2.	Lichtenstein MJ, Mulrow CD, Elwood PC. Guidelines for reading case-control studies. J Chronic Dis, 1987, 40(9): 893-903.
3.	Light RJ, Pillemer DB. Quantitative procedures. In Summing up: The Science of Reviewing Research: Harvard University Press, 1984.
4.	Matos E, Vilensky M, Boffetta P, et al. Lung cancer and smoking: a case-control study in Buenos Aires, Argentina. Lung Cancer, 1998, 21(3): 155-163.
5.	Droste JH, Weyler JJ, Van Meerbeeck JP, et al. Occupational risk factors of lung cancer: a hospital based case-control study. Occup Environ Med, 1999, 56(5): 322-327.
6.	劉雙, 劉澤英, 胡尚基. 吸煙與肺癌發生的回顧性分析. 心肺血管病雜志, 1999, 18(3): 222-223.
7.	Agudo A, Ahrens W, Benhamou E, et al. Lung cancer and cigarette smoking in women: a multicenter case-control study in Europe. Int J Cancer, 2000, 88(5): 820-827.
8.	Osann KE, Lowery JT, Schell MJ. Small cell lung cancer in women: risk associated with smoking, prior respiratory disease, and occupation. Lung Cancer, 2000, 28(1): 1-10.
9.	Simonato L, Zambon P, Ardit S, et al. Lung cancer risk in Venice: a population-based case-control study. Eur J Cancer Prev, 2000, 9(1): 35-39.
10.	Seow A, Poh WT, Teh M, et al. Fumes from meat cooking and lung cancer risk in Chinese women. Cancer Epidemiol Biomarkers Prev, 2000, 9(11): 1215-1221.
11.	顧雪松. 吸煙與肺癌危險性的病例對照研究. 江蘇預防醫學, 2000, 11(1): 18-19.
12.	Stellman SD, Takezaki T, Wang L, et al. Smoking and Lung Cancer Risk in American and Japanese Men: An International Case-Control Study. Cancer Epidemiology Biomarkers & Prevention, 2001, 10(11): 1193-1199.
13.	Rachtan J. Smoking, passive smoking and lung cancer cell types among women in Poland. Lung Cancer, 2002, 35(2): 129-136.
14.	Kubík AK, Zatloukal P, Tomásek L, et al. Lung cancer risk among Czech women: a case-control study. Prev Med, 2002, 34(4): 436-444.
15.	Sasco AJ, Merrill RM, Dari I, et al. A case-control study of lung cancer in Casablanca, Morocco. Cancer Causes Control, 2002, 13(7): 609-616.
16.	Chan-Yeung M, Koo LC, Ho JC, et al. Risk factors associated with lung cancer in Hong Kong. Lung Cancer, 2003, 40(2): 131-140.
17.	張亞旭, 吳樹嶺, 韓惠麗. 哈爾濱市南崗區103例肺癌患者相關危險因素對照分析. 中國初級衛生保健, 2003, 17(3): 32-33.
18.	De Stefani E, Deneo-Pellegrini H, Boffetta P, et al. Cigarette smoking and risk of large cell carcinoma of the lung: a case-control study in Uruguay. Lung Cancer, 2004, 43(3): 267-274.
19.	盧家強, 陳亞利, 霍敏琴. 順德容奇地區肺癌危險因素的病例對照研究. 中國自然醫學雜志, 2004, 6(1): 13-15.
20.	韓勇, 王云杰, 朱江, 等. 西安地區肺癌危險因素的病例對照分析. 現代腫瘤醫學, 2005, 13(2): 267-269.
21.	Franco-Marina F, Villalba-Caloca J, Corcho-Berdugo A. Role of active and passive smoking on lung cancer etiology in Mexico City. Salud Publica Mex, 2006, 48 (suppl 1): S75-S82.
22.	Neuberger JS, Mahnken JD, Mayo MS, et al. Risk factors for lung cancer in Iowa women: implications for prevention. Cancer Detect Prev, 2006, 30(2): 158-167.
23.	靳光付, 胡志斌, 馬紅霞, 等. 腫瘤家族史和吸煙在肺癌發生中的交互作用研究. 中華流行病學雜志, 2006, 27(12): 1095-1096.
24.	Nyberg F, Agrenius V, Svartengren K, et al. Environmental tobacco smoke and lung cancer in nonsmokers: does time since exposure play a role? Epidemiology, 1998, 9(3): 301-308.
25.	Zaridze D, Maximovitch D, Zemlyanaya G, et al. Exposure to environmental tobacco smoke and risk of lung cancer in non-smoking women from Moscow, Russia. Int J Cancer, 1998, 75(3): 335-338.
26.	Rapiti E, Jindal SK, Gupta D, et al. Passive smoking and lung cancer in Chandigarh, India. Lung Cancer, 1999, 23:183-189.
27.	Zhong L, Goldberg MS, Gao YT, et al. A case-control study of lung cancer and environmental tobacco smoke among nonsmoking women living in Shanghai, China. Cancer Causes and Control, 1999, 10: 607-616.
28.	Lee CH, Ko YC, Goggins W, et al. Lifetime environmental exposure to tobacco smoke and primary lung cancer of non-smoking Taiwanese women. Int J Epidemiol, 2000, 29(2): 224-231.
29.	Kreuzer M, Krauss M, Kreienbrock L, et al. Environmental tobacco smoke and lung cancer: a case-control study in Germany. Am J Epidemiol, 2000, 151(3): 241-250.
30.	Ko YC, Lee CH, Chen MJ, et al. Risk factors for primary lung cancer among non-smoking women in Taiwan. Int J Epidemiol, 1997, 26(1): 24-31.
31.	Mayne ST, Buenconsejo J, Janerich DT. Previous lung disease and risk of lung cancer among men and women nonsmokers. Am J Epidemiol, 1999, 149(1): 13-20.
32.	Brownson RC, Alavanja MC. Previous lung disease and lung cancer risk among women (United States). Cancer Causes Control, 2000, 11(9): 853-858.
33.	Kreuzer M, Heinrich J, Kreienbrock L, et al. Risk factors for lung cancer among nonsmoking women. Int J Cancer, 2002, 100(6): 706-713.
34.	Brenner AV, Wang Z, Kleinerman RA, et al. Previous pulmonary diseases and risk of lung cancer in Gansu Province, China. Int J Epidemiol, 2001, 30(1): 118-124.
35.	Ramanakumar AV, Parent ME, Menzies D, et al. Risk of lung cancer following nonmalignant respiratory conditions: evidence from two case-control studies in Montreal, Canada. Lung Cancer, 2006, 53(1): 5-12.
36.	劉恩菊, 項永兵, 金凡, 等. 上海市區非吸煙女性肺癌病例對照研究的多因素分析. 腫瘤, 2001, 21(6): 421-425.
37.	Gorlova OY, Zhang Y, Schabath MB, et al. Never smokers and lung cancer risk: a case-control study of epidemiological factors. Int J Cancer, 2006, 118(7): 1798-1804.
38.	Wünsch-Filho V, Boffetta P, Colin D, et al. Familial cancer aggregation and the risk of lung cancer. Sao Paulo Med J, 2002, 120(2): 38-44.
39.	De Stefani E, Boffetta P, Brennan P, et al. Occupational exposures and risk of adenocarcinoma of the lung in Uruguay. Cancer Causes Control, 2005, 16(7): 851-856.
40.	Etzel CJ, Amos CI, Spitz MR. Risk for smoking-related cancer among relatives of lung cancer patients. Cancer Res, 2003, 63(23): 8531-8535.
41.	Wu PF, Lee CH, Wang MJ, et al. Cancer aggregation and complex segregation analysis of families with female non-smoking lung cancer probands in Taiwan. Eur J Cancer, 2004, 40(2): 260-266.
42.	Matakidou A, Eisen T, Bridle H, et al. Case-control study of familial lung cancer risks in UK women. Int J Cancer, 2005, 116(3): 445-450.
43.	Cassidy A, Myles JP, Duffy SW, et al. Family history and risk of lung cancer: age-at-diagnosis in cases and first-degree relatives. Br J Cancer, 2006, 95(9): 1288-1290.
44.	Wynder EL, Higgins ITT, Harris RE. The wish bias. J Clin Epidemiol, 1990, 43: 619.

1. Pirozynski M. 100 years of lung cancer. Respir Med, 2006, 100(12): 2073-2084.
2. Lichtenstein MJ, Mulrow CD, Elwood PC. Guidelines for reading case-control studies. J Chronic Dis, 1987, 40(9): 893-903.
3. Light RJ, Pillemer DB. Quantitative procedures. In Summing up: The Science of Reviewing Research: Harvard University Press, 1984.
4. Matos E, Vilensky M, Boffetta P, et al. Lung cancer and smoking: a case-control study in Buenos Aires, Argentina. Lung Cancer, 1998, 21(3): 155-163.
5. Droste JH, Weyler JJ, Van Meerbeeck JP, et al. Occupational risk factors of lung cancer: a hospital based case-control study. Occup Environ Med, 1999, 56(5): 322-327.
6. 劉雙, 劉澤英, 胡尚基. 吸煙與肺癌發生的回顧性分析. 心肺血管病雜志, 1999, 18(3): 222-223.
7. Agudo A, Ahrens W, Benhamou E, et al. Lung cancer and cigarette smoking in women: a multicenter case-control study in Europe. Int J Cancer, 2000, 88(5): 820-827.
8. Osann KE, Lowery JT, Schell MJ. Small cell lung cancer in women: risk associated with smoking, prior respiratory disease, and occupation. Lung Cancer, 2000, 28(1): 1-10.
9. Simonato L, Zambon P, Ardit S, et al. Lung cancer risk in Venice: a population-based case-control study. Eur J Cancer Prev, 2000, 9(1): 35-39.
10. Seow A, Poh WT, Teh M, et al. Fumes from meat cooking and lung cancer risk in Chinese women. Cancer Epidemiol Biomarkers Prev, 2000, 9(11): 1215-1221.
11. 顧雪松. 吸煙與肺癌危險性的病例對照研究. 江蘇預防醫學, 2000, 11(1): 18-19.
12. Stellman SD, Takezaki T, Wang L, et al. Smoking and Lung Cancer Risk in American and Japanese Men: An International Case-Control Study. Cancer Epidemiology Biomarkers & Prevention, 2001, 10(11): 1193-1199.
13. Rachtan J. Smoking, passive smoking and lung cancer cell types among women in Poland. Lung Cancer, 2002, 35(2): 129-136.
14. Kubík AK, Zatloukal P, Tomásek L, et al. Lung cancer risk among Czech women: a case-control study. Prev Med, 2002, 34(4): 436-444.
15. Sasco AJ, Merrill RM, Dari I, et al. A case-control study of lung cancer in Casablanca, Morocco. Cancer Causes Control, 2002, 13(7): 609-616.
16. Chan-Yeung M, Koo LC, Ho JC, et al. Risk factors associated with lung cancer in Hong Kong. Lung Cancer, 2003, 40(2): 131-140.
17. 張亞旭, 吳樹嶺, 韓惠麗. 哈爾濱市南崗區103例肺癌患者相關危險因素對照分析. 中國初級衛生保健, 2003, 17(3): 32-33.
18. De Stefani E, Deneo-Pellegrini H, Boffetta P, et al. Cigarette smoking and risk of large cell carcinoma of the lung: a case-control study in Uruguay. Lung Cancer, 2004, 43(3): 267-274.
19. 盧家強, 陳亞利, 霍敏琴. 順德容奇地區肺癌危險因素的病例對照研究. 中國自然醫學雜志, 2004, 6(1): 13-15.
20. 韓勇, 王云杰, 朱江, 等. 西安地區肺癌危險因素的病例對照分析. 現代腫瘤醫學, 2005, 13(2): 267-269.
21. Franco-Marina F, Villalba-Caloca J, Corcho-Berdugo A. Role of active and passive smoking on lung cancer etiology in Mexico City. Salud Publica Mex, 2006, 48 (suppl 1): S75-S82.
22. Neuberger JS, Mahnken JD, Mayo MS, et al. Risk factors for lung cancer in Iowa women: implications for prevention. Cancer Detect Prev, 2006, 30(2): 158-167.
23. 靳光付, 胡志斌, 馬紅霞, 等. 腫瘤家族史和吸煙在肺癌發生中的交互作用研究. 中華流行病學雜志, 2006, 27(12): 1095-1096.
24. Nyberg F, Agrenius V, Svartengren K, et al. Environmental tobacco smoke and lung cancer in nonsmokers: does time since exposure play a role? Epidemiology, 1998, 9(3): 301-308.
25. Zaridze D, Maximovitch D, Zemlyanaya G, et al. Exposure to environmental tobacco smoke and risk of lung cancer in non-smoking women from Moscow, Russia. Int J Cancer, 1998, 75(3): 335-338.
26. Rapiti E, Jindal SK, Gupta D, et al. Passive smoking and lung cancer in Chandigarh, India. Lung Cancer, 1999, 23:183-189.
27. Zhong L, Goldberg MS, Gao YT, et al. A case-control study of lung cancer and environmental tobacco smoke among nonsmoking women living in Shanghai, China. Cancer Causes and Control, 1999, 10: 607-616.
28. Lee CH, Ko YC, Goggins W, et al. Lifetime environmental exposure to tobacco smoke and primary lung cancer of non-smoking Taiwanese women. Int J Epidemiol, 2000, 29(2): 224-231.
29. Kreuzer M, Krauss M, Kreienbrock L, et al. Environmental tobacco smoke and lung cancer: a case-control study in Germany. Am J Epidemiol, 2000, 151(3): 241-250.
30. Ko YC, Lee CH, Chen MJ, et al. Risk factors for primary lung cancer among non-smoking women in Taiwan. Int J Epidemiol, 1997, 26(1): 24-31.
31. Mayne ST, Buenconsejo J, Janerich DT. Previous lung disease and risk of lung cancer among men and women nonsmokers. Am J Epidemiol, 1999, 149(1): 13-20.
32. Brownson RC, Alavanja MC. Previous lung disease and lung cancer risk among women (United States). Cancer Causes Control, 2000, 11(9): 853-858.
33. Kreuzer M, Heinrich J, Kreienbrock L, et al. Risk factors for lung cancer among nonsmoking women. Int J Cancer, 2002, 100(6): 706-713.
34. Brenner AV, Wang Z, Kleinerman RA, et al. Previous pulmonary diseases and risk of lung cancer in Gansu Province, China. Int J Epidemiol, 2001, 30(1): 118-124.
35. Ramanakumar AV, Parent ME, Menzies D, et al. Risk of lung cancer following nonmalignant respiratory conditions: evidence from two case-control studies in Montreal, Canada. Lung Cancer, 2006, 53(1): 5-12.
36. 劉恩菊, 項永兵, 金凡, 等. 上海市區非吸煙女性肺癌病例對照研究的多因素分析. 腫瘤, 2001, 21(6): 421-425.
37. Gorlova OY, Zhang Y, Schabath MB, et al. Never smokers and lung cancer risk: a case-control study of epidemiological factors. Int J Cancer, 2006, 118(7): 1798-1804.
38. Wünsch-Filho V, Boffetta P, Colin D, et al. Familial cancer aggregation and the risk of lung cancer. Sao Paulo Med J, 2002, 120(2): 38-44.
39. De Stefani E, Boffetta P, Brennan P, et al. Occupational exposures and risk of adenocarcinoma of the lung in Uruguay. Cancer Causes Control, 2005, 16(7): 851-856.
40. Etzel CJ, Amos CI, Spitz MR. Risk for smoking-related cancer among relatives of lung cancer patients. Cancer Res, 2003, 63(23): 8531-8535.
41. Wu PF, Lee CH, Wang MJ, et al. Cancer aggregation and complex segregation analysis of families with female non-smoking lung cancer probands in Taiwan. Eur J Cancer, 2004, 40(2): 260-266.
42. Matakidou A, Eisen T, Bridle H, et al. Case-control study of familial lung cancer risks in UK women. Int J Cancer, 2005, 116(3): 445-450.
43. Cassidy A, Myles JP, Duffy SW, et al. Family history and risk of lung cancer: age-at-diagnosis in cases and first-degree relatives. Br J Cancer, 2006, 95(9): 1288-1290.
44. Wynder EL, Higgins ITT, Harris RE. The wish bias. J Clin Epidemiol, 1990, 43: 619.

《中國循證醫學雜志》

肺癌危險因素的Meta分析

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《中國循證醫學雜志》

肺癌危險因素的Meta分析

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