摘要
目的系统评价甲状腺癌的主要影响因素，为进一步制定甲状腺癌的预防策略提供参考依据。方法计算机检索PubMed、The Cochrane Library、中国生物医学文献数据库（CBM）、中国知网（CNKI）、维普（VIP）和万方（WanFang Data）数据库．纳入关于甲状腺癌危险因素的病例一对照研究，检索时限均为数据库建库起至2016年6月10日。由2名评价员按纳人排除标准独立筛选文献，提取资料并评价纳入研究的方法学质量后，采用RevMan5．2软件进行Meta分析。结果共纳入19个研究，合计4813例甲状腺癌患者和6068例对照（符合配对条件的非肿瘤患者）。Meta分析显示，甲状腺癌发生的危险因素主要有：甲状腺良性疾病病史[比值比（OR）=7131，95％可信区间（95％CI，4．37，12．23）]；甲状腺癌家族史[OR=5．13，95％CI（3．20，8．23）]；高碘饮食（海洋动物食品，OR=4．15，95％CI（2．47，6．99）]；CT检查史[（OR=3．99，95％CI（2．10，7．60）]；不良情绪[爱生闷气，OR=3．31，95％CI（2．23，4．91）]；体质指数（BMI）〉25[OR=2．62，95％CI（1．73，3．97）]；压力大、焦虑[OR=2．60，95％c，（1．61，4.21）]；与人相处不融洽[OR=2．46，95％CI（1．59，3．81）]；女性怀孕次数3次以上[OR=2．03，95％CI（1．50，2．76）]；女性初潮年龄〈13、14岁[OR=1．59，95％a（1．06，2．37）]。结论甲状腺良性疾病病史、甲状腺癌家族史、高碘饮食、CT检查史、BMI〉25、不良情绪、社会交往、怀孕次数等是甲状腺癌发生的独立危险因素．应根据这些危险因素采取相应预防控制措施。
Objective Evaluating the main risk factors of thyroid cancer systematicaly, to provide reference for the further development of thyroid cancer prevention strategies. Methods Such databases as PubMed, Coehrane Library, CBM, CNKI, VIP and WanFang were searched from the date of their establishment to June 10 2016 to collect the case-control studies on thyroid cancer. After study selection, assessment and data extraction was conducted by two reviewers independently, recta-analysis was performed by using the RevMan 5.1 software. Results Nineteen studies involving 4 813 thyroid cancer patients and 6 068 comparions were selected. The results of recta- analysis showed that： the risk factors of thyroid cancer mainly included history of benign thyroid disease [odds ratio （OR） = 7.31,95% confidence interval （95%CI, 4.37, 12.23）], family history of thyroid cancer [OR = 5.13, 95%CI （3.20, 8.23）], high iodine diet [（marine animal food, OR = 4.15, 95%CI （2.47, 6.99）], CT inspection history [OR = 3.99, 95%CI （2.10, 7.60）], Negative emotions [sulking, OR = 3.31, 95%CI （2.23, 4.91）], BMI greater than 25 [OR = 2.62, 95%CI （1.73, 3.97）], high pressure and anxious [OR = 2.60, 95%CI （1.61, 4.21）], getting along with people not harmoniously [OR = 2.46, 95%CI （1.59, 3.81）], the number of pregnancies of women more than three times [OR = 2.03, 95%C/（1.50, 2.76）], age of menarche less than 13, 14 years old [OR = 1.59, 95%C/（1.06, 2.37）]. Conclusions Thyroid benign disease history, family history of thyroid cancer, high iodine diet, CT examination, BMI greater than 25, bad mood, social interaction, number of pregnancies and other factors are the independent risk factors for thyroid cancer. Corresponding prevention and control measures should be taken according to these risk factors.
出处
《中华地方病学杂志》
CAS
CSCD
北大核心
2017年第4期250-256,共7页
Chinese Journal of Endemiology
