| Objective(1) Exploring the major risk factors and etiologic model of gastric carcinoma by clinical epidemiological study, in order to provide the scientific basis for preventive measures.(2) To evaluate the association between Epstein-Barr virus (EBV) and susceptibility to gastric carcinoma and to provide evidence for the etiology and preventive measures of gastric carcinoma. Investigating the risk degree of different oncogenes and anti-oncogenes on gastric carcinoma's occurrence, progress, mouse out theoretics basis on gene level for gastric carcinoma by laboratory epidemiological studyMaterials and Method(1) Alimentary tract tumors were formed the cohort set of this study, all were hospitalized in Wuhan university Zhongnan Hospital or Wuhan Army Hospital in 1st January, 2000 to 31st July, 2003. Eliminating secondary gastric cancer, 150 gastric carcinomas were formed the case group of this study. Diagnosis basis is CT and index of laboratory, for example, AFP, ALT, AST and so on, combining with clinical symptom, some of cases were done pathological Biopsy. One methods were used to select controls in this study. For each case, one other alimentary tract tumors was randomly selected from the cohort set as control, resulting a final control group of 150 individuals.The study was based on the questionnaire by graduate student Public Health School Wuhan University. The study content composed of general characteristics, personal habits and history of viral hepatitis, family history of tumor and the habit of dietary, including sex, age, profession, education, dietary habit, alcohol consumption, cigarette smoking and drinking tea and so on. The index of laboratory includeHP-Ab, HBsAg, HBsAb, HbeAg, HBeAb, HbcAg, HBcAb and HCV-Ab by Enzyme-linkedimmunoadsordent assay (ELISA).SPSS and SAS were used to analyze data in this study. Univariate analysis was the first analyzing step for sample . Then, variables showing associations with the risk of Gastric carcinoma at PO.10 level were further tested in stepwise non-conditional and conditional Logistic regression models for sample , respectively. The final model consisted of those variables showing a significant level at P<0.05. OR value and its 95% CI were calculated for these factors.(2)Extensively reviewing any language literature collecting the related with electronic documents in combination with manual retrieve and using Meta-analysis to do a quantitive analysis. Case-control study about P53^ P21RAS^ Epstein-Barr virus (EBV) and susceptibility to gastric carcinoma . Fixed-effect model(FEM) and random-effect model (REM) of Meta-analysis were applied to process data.Result(l)In the sample, age was closely associated with gastric carcinoma , the result showed that the incidence of gastric carcinoma increased as age increased, it reached the max at the age of 35 to 65 years old, then drop down as age increased. The result showed that the average diagnosed age of gastric carcinoma was 56.45±13.712652, significantly younger than that of controls, which was50.68±12.807 years old (PO.001).In the univariate analysis of sample, compared with female, the OR value of male for gastric carcinoma was 4.583. After transforming the profession and blood type into dunny variable, it was suggested that farmer, A blood type,were correlation with gastric carcinoma, which OR values were 2.737,3.101, respectively.Meanwhile, there was interaction between tobacco smoking and alcohol consumption, the OR value of gastric carcinoma for who was both cigarette smokers and alcohol drinker compared with who was neither smoke nor drink was 6.856; the OR value of gastric carcinoma for cigarette smokers compared with who was neither smoke nor drink after adjustment for alcohol consumption was 1.496; the OR value of HCC foralcohol drinker compared with who was neither smoke nor drink after adjustment for cigarette smoking was 2.886; the OR value of gastric carcinoma for history of viral hepatitis was 0.734; the OR value of gastric carcinoma for seropositives of HBsAg, HBsAb, HBeAg, HBeAb, HBcAg, HBcAb were 0.961,3.496,0.309,0.642,0,0.396, respectively.The result of multivariate analysis showed that the main risk factors were sex, , jobless,farmer,A blood type in the sample, whose OR value of gastric carcinoma were 4.583, 1.052, 2.794? 3.986, respectively.(2)The summary odds ratio of gastric carcinoma risk of 10 studies associated with Epstein-Barr virus (EBV) was 9.58, 95%confidence interval was 6.82—13.33. The summary odds ratio of gastric carcinoma risk of 16 studies associated with p53 was 11.780, 95% confidence interval was 9.211~ 15.062. The summary odds ratio of gastric carcinoma risk of 9 studies associated with Ras P21 was 23.786, 95%confidence interval was 13.144—43.043Conclusion(l)Factors founded in this study, which were closely associated with gastric carcinoma, were sex, jobless, farmer, A blood type in sample 1.(2) The result indicates that Ras P21 is associated with a modest increase in the risk of gastric carcinoma.(3)The result indicates that Epstein-barr virus is associated with a modest increase in the risk of gastric carcinoma The result indicates that p53 is associated with a modest increase in the risk of gastric carcinoma.(4)The result indicates that oncogene , EB virus and entironment in the risk of gastric carcinoma.
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