鼻咽癌多重危險因子之世代追蹤研究

A Cohort Study on Multiple Risk Factors of Nasopharyngeal Carcinoma

林宇旋(Yu-Hsuan Lin) ； 陳建仁(Chien-Jen Chen)

《中華公共衛生雜誌》 16卷6期 (1997/12) Pp. 466-477

https://doi.org/10.6288/CJPH1997-16-06-02

摘要

本研完以台灣地區六個鄉鎮之9775名男性為對象，採世代追蹤研究法探討鼻咽癌與多重危險因子相關。研究對象於收案時，均利用結構式問卷收集其人口學基本特徵與各項危險因子暴露資料，並採集血液檢體進行EB病毒抗體測定。在平均8.1年追蹤期間，共發現13名鼻咽癌新病例，以Cox氏比例危害模式與多變項對數迴歸分析結果如下：EB病毒VCA/IgA抗體效價大於1:10或DNase抗體高於2.0單位者，罹患鼻咽癌之相對危險性顯著偏高。無論被診斷出鼻咽癌的時間是在追蹤兩年內或兩年後，抗體效價高者，皆具有顯著偏高之鼻咽癌危險性。在調整年齡與病毒抗體效價後，攝取豆類發酵食物、鼻竇炎病史和鼻咽癌家族史，皆與鼻咽癌的發生有關。EB病毒DNase抗體效價偏高與抽菸、攝取豆類發酵食物間則有顯著交互作用。

關鍵字

鼻咽癌 ； 世代追蹤研究 ； 危險因子

並列摘要

In order to explore multiple risk factors of nasopharyngeal carcinoma (NPC), a total of 9775 male adult residents in six townships were studied. Sociodemographic characteristics, history of cigarettes smoking and alcohol drinking, dietary habits, personal history of sinusitis and family history of NPC were collected by well-trained interviewers with structured questionnaires at the recruitment. Blood samples were also obtained and tested for immunoglobulin A antibodies against viral capsid antigen (anti-EBV VCA/IgA) of Epstein-Barr virus (EBV) and antibodies to EBV-specific DNase (anti-EBV DNase).
A total of 13 new NPC cases occurred during an average follow-up period of 8.1 years. Cox's proportional hazard models and multiple logistic regression models were used to analyze multiple risk factors for NPC. The multivariate-adjusted relative risk of developing NPC for anti-EBV VCA/IgA was 40.6 (95%CI 7.5-220.1) for a titer equal to 1:10, and 726.7 (95%CI 177, 9-2967.7) for a titer greater than or equal to 1:40. The multivariate-adjusted relative risk for anti-EBV DNase was 3.4 (95%CI 0.4-32.9) for a level of 2.0- 3.9 units, 34.1 (95%CI 6.8-171.1) for 4.0-5.9 units, and 113.6 (95%CI 27.7-465.9) for 6.0 or more units. Stratification analysis of NPC cases diagnosed within and after first two years of follow-up, the significantly high relative risks associated with elevated EBV antibodies remained. After adjustment for age and anti-EBV antibody level, consumption of fermented soy bean products, family history of NPC, and personal history of sinusitis were also associated with the development of NPC. Interactions were found between seropositivity of anti-EBV DNase and cigarette smoking and fermented soy bean products consumption.

並列關鍵字

nasopharyngeal carcinoma ； cohort study ； risk factors