中国非吸烟人群环境烟草烟雾暴露与肺癌发生关联的Meta分析

摘要

Objective To investigate the relationship between the environmental tobacco smoke (ETS) and lung cancer by Meta-analysis. Methods We used“lung cancer/lung neoplasm”,“non-smokingon-smoker”,“China/Chinese”,“case-control/case control”,“risk factor”,“environmental tobacco smoke/passive smoking”as key words, to search papers in databases including Chinese BioMedical Literature (CBM), China National Knowledge Internet (CNKI), Wanfang, Vip Citation Databases (VIP), PubMed and Web of Science databases, and collected the case-control studies on ETS and lung cancer among Chinese non-smokers from January 1999 to December 2013. A total of 129 research papers were collected. RevMan 5.2 software was used to calculate combined odds radio (OR) and 95%CI. Results Qualified 18 literatures were included, total cases 6 145 and controls 8 132. Consolidated results showed that ETS exposure could increase the risk of lung cancer, combined OR(95%CI)=1.52(1.42-1.64). Stratified analysis showed that ETS exposure was found to be significantly associated with an increasing risk of the lung cancer on non-smoking women and men, and combined OR(95%CI) were 1.58(1.42-1.75) and 1.34(1.08-1.65), respectively; the ETS exposure from family or the working environment could increase the risk of lung cancer, and combined OR(95%CI) were 1.48(1.20-1.82) and 1.38(1.13-1.69) respectively;childhood exposure and adult exposure were no significant statistical significance, and combined OR(95%CI) were 1.37(0.98-1.91), and 1.34(0.97-1.85) respectively. Conclusion Environmental tobacco smoke exposure was a significant risk factor of lung cancer among non-smokers in China.%目的：采用Meta分析方法综合评价中国非吸烟人群环境烟草烟雾（ETS）暴露与肺癌发生危险的关系。方法以“肺癌/肺肿瘤”、“非吸烟”、“病例对照”、“危险因素”、“环境烟草烟雾/被动吸烟”、“lung cancer/lung neoplasm”、“non-smokingon-smoker”、“China/Chinese”、“case-control/case control”、“risk factor”、“environmental tobacco smoke/passive smoking”为检索词，检索中国生物医学文献数据库、中国学术期刊全文数据库、万方知识服务平台、中国科技期刊全文数据库、PubMed和Web of Science数据库，系统收集1999年1月至2013年12月公开发表的有关中国非吸烟人群ETS暴露与肺癌发生关联的病例-对照研究，共检索到相关文献129篇。采用RevMan 5.2软件进行分析，计算合并OR（95%CI）值。结果最终纳入18篇文献，累计肺癌病例6145例，对照8132例。合并分析结果显示，中国非吸烟人群ETS暴露可增加肺癌发病的风险，合并OR（95%CI）值为1.52（1.42~1.64）；分层分析显示，ETS暴露与非吸烟女性及男性肺癌发生的关联均有统计学意义，合并OR（95%CI）值分别为1.58（1.42~1.75）和1.34（1.08~1.65）；来源于家庭及工作环境的ETS暴露均可增加患肺癌的风险，合并OR（95%CI）值分别为1.48（1.20~1.82）和1.38（1.13~1.69）；儿童期及成年期ETS暴露与肺癌发生的关联无统计学意义，合并OR（95%CI）值分别为1.37（0.98~1.91）和1.34（0.97~1.85）。结论 ETS暴露是中国非吸烟人群肺癌发病的重要危险因素。