| ObjectiveTo analyze the factors which influenced the incidence of Feicheng’s esophageal squamous cell carcinoma,and determine the distribution of COX-2-765 polymorphism in the case group and the control group,and the correlations with esophageal squamous cell carcinoma,to analyze the interactions between COX-2-765 polymorphism and influencing factors in the pathogenesis of esophageal cancer;to determine the relationship between Hp infection and the incidence of esophageal squamous cell carcinomaMethodsA group case-control study was used to analyze the factors of esophageal squamous cell carcinoma,including 202 patients and 236 controls.Using Taqman probe to detect the COX-2-765 polymorphisms,Hp typing testing was detected by Western blotting;using the additive model and multiplicative model,to calculate the interactions between COX-2-765 genotype and environmental factors.SPSS 20.0 and SAS 9.0 was used for statistical analysis.The quantitative data was analyzed by independent samples t test,using(x±s)to describe,and chi-square was used to analyze categorical data,none-conditional logistic stepwise regression was applied in the multivariable analysis.After the multivariable analysis,the significant factors were selected to analyze interactions with COX-2-765 by additive and multiplicative model,respectively.The additive model was analyzed by crossover analysis,and logistic regression was used to analyze multiplicative model.Using Hardy Weinberg test to explore whether there was difference between observations and expectations in control group;The P value which was less than or equal to 0.05 suggested that the differences was significant.Results1.Age and family income between the case and the control group had no statistical significance(P>0.05),however,there were statistical differences about gender,occupation,education,marriage and personality between the two groups(p<0.05).2.Frequencies of COX-2-765 GG and GC were 68.3%and 31.7%in case group,and 94.1%,5.9%in control group respectively(X2=49.309,P<0.001);Allele frequencies of C were 15.8%in case group higher than 3.0%in control group(χ2=44.489,P<0.001);Compared with COX-2-765GG,OR(95%CI)of COX-2-765GC was 7.354(3.972～13.617).3.Univariate analysis:Applying chi square test to analyze the environmental factors of esophageal cancer,health status included whether suffering from digestive system inflammation,acid reflux,bad breath,indigestion,melana,living environments involved whether there were factories,air and water pollution around residence,eating habits was hot food,dry and hard food,eating speed,taste,fruit and vegetables,leftovers,eating vinegar,garlic,onions and ginger,drinking unboiled water,water-related factors included the water and it’s smell a decade ago,alcohol and tobacco factors involved smoking,passive smoking,daily smoking,years of smoking,drinking,daily drinking,years of drinking,family history of cancer were first-degree relatives and second-degree relatives.4.Infection of Helicobacter pylori(Hp):the infection rate of Hp type Ⅰ was 14.9%in case group,and 23.7%in control group(χ2=5.436,P=0.020);the infection rate of HP typeⅠ was 40.6%in case group,and 45.8%in control group(χ2=1.184,P=0.277);the total infection rate of Hp was 41.6%in case group,and 47.5%in control group(χ2=1.519,P=0.218).5.Analysis of multiple logistic stepwise regression factors showed that gender,education level,whether suffering from digestive system inflammation,acid reflux,melena,whether there were factories,air and water pollution around residence,eatingvinegar and ginger,the water a decade ago,drinking unboiled water,passive smoking and family history of first-degree relatives were the main influencing risk factors of esophageal carcinoma,the OR and 95%CI respectively:5.888(95%CI:2.782～21.555),0.108(95%CI:0.042～0.278),23.430(95%CI:3.215～170.760),2.392(95%CI:1.049～5.455),27.799(95%CI:4.706～164.300),7.508(95%CI:2.147～26.252),14.865(95%CI:5.326～41.489),25.184(95%CI:5.437～116.655),30.417(95%CI:6.641～139.373),0.372(95%CI:0.199～0.696),2.217(95%CI:1.165～4.214),9.964(95%CI:2.309～42.987),21.477(95%CI:6.207～74.279),18.320(95%CI:3.254～103.210),0.165(95%CI:0.044～0.616).6.Interactions between COX-2-765 and the influencing factors,the results of the additive model and multiplicative model showed that COX-2-765 genotype and passive smoking had additive model interaction,and the S was 5.256;COX-2-765 genotype and acid reflux,whether there were factories,air and water pollution around residence,the water a decade ago and passive smoking had multiplicative model interaction,the interaction indexs were 1.101,2.842,1.382,1.080,1.781 and 2.011 respectively.Conclusions1.COX-2-765 C allele gene may be a heredity predisposing gene of esophageal cancer in the people of Feicheng city.COX-2-765 genotype and acid reflux,whether there were factories,air and water pollution around residence,the water a decade ago and passive smoking had synergistic interactions.2.The infection rate of Hp type Ⅰ was 14.9%in the case group and 23.7%in the control group,so Hp type Ⅰ infection may reduce the risk of esophageal squamous cell carcinoma.3.The people suffering from digestive system inflammation,acid reflux and melena may be more susceptible to esophageal squamous cell carcinoma,the factories around residence could lead to air and water pollution,and may increase the risk of esophageal cancer,the people whose drinking water a decade ago was river or well water,especially those liking to drink unboiled water may be predisposed to esophageal cancer,the crowd who eating less vinegar and more ginger,had passive smoking and family history of first-degree relatives were more likely to suffer esophageal cancer. |
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