台灣南部地區前列腺癌相關危險因子之研究

中文摘要研究背景及目的: 台灣地區前列腺癌的發生率在過去十年急速增加在2001年已成為全國死亡原因第八位，共造成693位死亡。因此我們在南台灣進行一個案對照研究法，來探討前列腺癌環境暴露與生活飲食型態的危險因子，並以尋找預防之道。研究材料與方法: 在2000年12月至2003年1月期間，主要從高雄醫學大學附設醫院及高雄榮總醫院共收集177位新診斷，經病理證實的前列腺癌病例，另從醫院健檢義診收集177位年齡配對(+-2歲)的健康男性，並且其血清指數小於4ng/ml當作健康對照組。另從高雄醫學大學附設醫院收集，經醫師診斷前列腺肥大的病人當作前列腺肥大對照組。所有的對象須經過問卷調查以獲得社會經濟特徵、生活型態飲食習慣、環境暴露情形、遺傳史。以卡方檢定及多邏輯迴歸式分析前列腺癌的危險因子，使用統計軟體是以SPSS 8.0版。結果: 個案組與健康對照組，及前列腺肥大對照組的平均年齡分別為72.8歲與72.1歲及68.9歲 ( p= 0.63; p= 0.001 ) 。在多變項邏輯式迴歸分析後，在個案組與健康對照組中，發現運動習慣會降低前列腺癌0.42倍危險性 (95% CI= 0.24-0.71) ；喝牛奶會降低0.48倍危險性 (95% CI= 0.29-0.80) ；而發現食用泡麵習慣會增加3.97 (95% CI= 1.66-9.49) ；前列腺肥大病史會增加4.58倍危險性 (95% CI = 2.79-7.50) ，結石病史會增加3.61倍危險性 (95% CI = 1.12-11.65) 及在20-40歲之間有每週一次以上有硝製飲食習慣會增加6.34倍的危險性 (95% CI= 2.11-18.1) 、醃燻飲食習慣會增加3.99倍危險性 (95% CI= 1.11-14.36) 、豆類發酵飲食會增加16.09倍危險性 (95% CI= 6.15-42.0) 、鹽漬飲食習慣會增加6.80倍危險性 (95% CI= 2.52-18.3) ，在20-40歲之間有每月1-3次有硝製飲食習慣會增加4.13倍危險性 (95% CI= 2.36-7.24) ，豆類發酵飲食習慣會增加4.29倍危險性 (95% CI= 2.44-7.55) ，鹽漬飲食習慣會增加4.84倍危險性 (95% CI=2.77-8.47) 。而個案組與前列腺肥大對照組中，發現結石病史會降低0.35倍危險性 (95% CI= 0.18-0.65) 及20-40歲有醃燻飲食習慣每月1-3次會降低0.49倍危險性 (95% CI= 0.29-0.83) ；發現染髮習慣會增加2.20倍危險性 (95% CI= 1.23-3.91) ，喝1-36年間的酒 (95% CI= 1.23-4.69) ;及20-40歲間有吃肥肉習慣會增加2.29倍危險性(95% CI= 1.23-4.15) 。結論: 某些環境暴露與生活飲食習慣可能與前列腺癌的危險性有關，對其生物學上的機轉，需進一步去探討，可幫助我們預防前列腺癌的發生。關鍵字: 前列腺癌,個案對照研究,危險因子。

關鍵字

前列腺癌；個案對照研究法；危險因子

並列摘要

英文摘要 Background and purpose: The incidence of prostate cancer has been rapidly increasing in the past 10 years in Taiwan. It became the eighth most common cause of cancer-related death resulting in 693 deaths in 2000 . A case-control study was conducted to investigate the environmental and life-style risk factors of prostate cancer in southern Taiwan. Materials and Methods: Between December 2000 and January, 2003. 177 pathologically proved newly-diagnosed prostate cancer patients were entrolled from Kaohsiung Medical University and Kaohsiung Veteran General Hospital. 177 age-matched (+-2 years) , healthy male with PSA below 4 ng/ml were recruited from general health examination to serve as the control group. Diagnosed benign prostatic hyperplasia (BPH) control were entrolled from Kaohsiung Medical University. Subjects were interviewed in person to collect information reguarding sociodemographic , characteristics , life-style, diet , enviromentals , family history. Chi-square test and logistic regression analysis using SPSS.8.0 software were performed to identify significant risk factors of prostate cancer. Result: The mean age in case, health control, and BPH control were 72.8 years, 72.1 years, and 68.9 years ( p= 0.63; p< 0.001 ) 。. In a multivariable logistic regression analysis, we found case and health control significant variables including: active exercise had 0.42-fold (95% CI= 0.24-0.71) ; milk consumption had 0.42-fold (95% CI= 0.29-0.80) risk of prostate cancer , and found noodle instant consumption had 3.97-food (95% CI= 1.66-9.49), BPH history had 4.58-food (95% CI= 2.79-7.50) , stone history had 3.61-fold (95% CI= 1.12-11.65) increased risk of prostate cancer, and.20 to 40 years >= 1 time per week, consumption of nitrate food had 6.34-fold (95% CI= 2.11-18.1), smoked food had 3.99-fold (95% CI= 1.11-14.36) , fermented bean producted had 16.09-fold (95% CI= 6.15-42.0) , salted food had 6.80-fold (95% CI= 2.51-18.3) ; 1-3 time per month, nitrate food had 4.13-fold (95% CI= 2.36-7.24) ; fermented bean producted had 4.29-fold (95% CI= 2.44-7.55), salted food had 4.84-fold (95% CI= 2.77-8.47) increased risk of prostate cancer. Case an BPH control found significant variables including: stone history had 0.35-fold (95% CI= 0.18-0.65) , 1-3 times per month consumption of smoked food had 0.49-fold (95% CI= 0.29-0.83) risk of prostate cancer; and found positive significant variables including: hair dye had 2.20-fold (95% CI= 1.23-3.91), former drinker 1 to 36years had 2.41-fold (95% CI= 1.23-4.69) , and 20 to 40 years consumption of fat meat had 2.29-fold (95% CI= 1.23-4.15) increased risk of prostate cancer. Conclusions: Some enviromental and life-style factors may have associated with prostate cancer risk. A better understanding about these biological mechanisms will be helpful to prevent from the development of prostate cancer in the future. Key word: Prostate cancer, Case-control study, Risk factors.