脑胶质瘤危险因素Meta分析及危险因素控制后发病率的变化趋势

摘要

Objective To systematically analyze the risk factors for gliomas and evaluate the tendency of incidence change after controlling those risk factors in order to provide evidence for primary prevention of the disease. Methods Case-control studies on risk factors of brain gliomas were collected and screened for the main risk factor. Meta analysis was used to calculate the overall odds ratio (OR) and 95% confidence intervals for each selected factor. Then,we estimated population attributable risk proportion (PARP) and evaluated the tendency of incidence change after controlling risk factors. Results Thirteen articles on risk factors of glioma were selected. The first 5 risk factors were Plumbum exposure (OR=7.060),gasoline exposure (OR=3.242), heavy or prolonged smoking (OR=2.960), family history of tumor (OR= 2.612), and frequent intake of toasted or cured food (OR=2.544). The factors for high PARP were heavy or prolonged smoking (30.979%), frequent intake of toasted or cured food (27.713%),rays or electromagnetic field exposure (23.964%),and gasoline exposure (13.799%). If the exposure rates of these risk factors decrease by 25% and 50% in the near future, the incidence of glioma would reduce by 7.745%, 5.937%,5.991%,3.450% and 15.490%, 11.875%, 11.982%,6.900% respectively. Conclusion Unhealthy living habits and occupational hazards are closely related to glioma incidence. Effective preventive measures related to these risk factors should be conducted to control the onset and development of glioma.%目的 分析脑胶质瘤发病的危险因素,并评估危险因素控制后其发病率的变化趋势,为该病的一级预防提供证据.方法 收集国内外有关脑胶质瘤危险因素的病例对照研究,筛选出主要危险因素,采用Meta分析计算各个危险因素的合并比值比(OR)和95％可信区间,采用Egger's检验估计发表偏倚.结合人群暴露率,计算目前人群归因危险度百分比,评估危险因素控制后发病率的变化情况.结果 共筛选出13篇文献,与脑胶质瘤发病关联程度较高的前5位因素分别是金属铅接触史(0R=7.060)、汽柴油接触史(OR=3.242)、大量或长时间吸烟(OR=2.960)、肿瘤家族史(OR=2.612)、喜食腌渍熏烤食品(OR=2.544).获得较大人群归因危险度百分比的因素依次为大量或长时间吸烟( 30.979％)、喜食腌渍熏烤食品(27.713％)、射线或电磁场接触史( 23.964％)、汽柴油接触史(13.799％),若上述4种因素暴露率在若干年后下降25％或50％,则脑胶质瘤发病率分别下降7.745％、5.937％、5.991％、3.450％和15.490％、11.875％、11.982％、6.900％.结论 不良生活习惯与某些职业性危害因素和脑胶质瘤的发病关系密切,应从改善生活行为习惯和加强对职业有害因素接触人群保护这两方面采取积极有效的预防措施.