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目的 探索南方食管癌现场中亚硝基化合物综合危险因素。方法 在南方食管癌高发区南澳县和低发区陆丰县各随机选择12 0名35～6 4岁健康男性居民,收集2 4小时膳食和3天12小时夜尿。分别为空白尿样、5 0 0mg脯氨酸+2 0 0mg维生素C(VC)负荷尿样和5 0 0mg脯氨酸负荷尿样。测定总亚硝基化合物(TNOC)、挥发性亚硝胺、亚硝基氨基酸(NAAs)和还原型VC。用非条件logistic模型分析各类亚硝胺摄入水平和排泄水平、NAAs内源性合成能力、VC的营养状况及其对内源性合成的阻断能力等综合因素与食管癌死亡率的关系。结果 非条件logistic回归分析筛选出两个食管癌亚硝胺危险因素—膳食TNOC含量(OR为9 6. 13,95 %CI 1 92 .1～4 8 .115 )和服VC后尿NAAs浓度(OR为1 137,95 %CI为1 0. 0 1～1 2 .98)。结论 膳食TNOC高含量和VC对NOC内源性合成的低阻断能力是南方食管癌高死亡率的两个重要危险因素。
Objective To explore the integrated risk factors of nitroso compounds in the site of southern esophageal cancer. Methods A total of 120 healthy male residents aged 35-64 years were randomly selected from Nan’ao County in the high incidence area of southern esophageal cancer and Lufeng County in the low incidence area for 24 hours and nocturia for 3 days for 12 hours. Respectively, blank urine samples, 500 mg proline + 200 mg vitamin C (VC) -loaded urine sample and 500 mg proline-loaded urine sample. Total nitroso compounds (TNOC), volatile nitrosamines, nitroso amino acids (NAAs) and reduced VC were measured. The non-conditional logistic model was used to analyze the relationship between various factors such as intake and excretion of various nitrosamines, endogenous NAAs synthesis, nutritional status of VC and their ability to block endogenous synthesis, and esophageal cancer mortality . Results The unconditional logistic regression analysis showed that the risk factors of nitrosamine in two esophageal carcinomas - dietary TNOC content (OR = 9.66, 95% CI: 92.1-181.8115) Was 1 137, 95% CI was 1 0 0 1 ~ 1 2 .98). Conclusions Dietary TNOC levels and the low blocking ability of VC on NOC endogenous synthesis are two important risk factors of high esophageal cancer mortality in the South.