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目的探讨天津市联苯胺职业接触人群膀胱癌的主要危险因素,以确定高危人群。方法对天津市联苯胺职业接触人群中106例膀胱癌和同时期、同车间的未发生膀胱癌的106人进行成组病例-对照研究,通过单因素和多因素非条件Logistic回归分析筛选职业人群中膀胱癌的主要危险因素,同时分析病例组与对照组尿中脱落细胞检查情况,为职业肿瘤的早期发现及高危人群的确定提供参考依据。结果单因素及多因素分析结果显示,联苯胺职业接触人群膀胱癌危险因素包括接触联苯胺浓度、专业工龄、吸烟(P<0.05);多因素分析结果表明,联苯胺职业接触人群膀胱癌的主要危险因素为高接触浓度(OR=4.752,95%CI=2.458~9.190)、专业工龄(OR=2.557,95%CI=1.394~4.692)、吸烟(OR=2.011,95%CI=1.020~3.966)。病例组巴氏分级Ⅱ级及以上和定量荧光影像分析(QFIA)阳性检出均高于对照组,P<0.05。结论高浓度接触、专业工龄超过5年、吸烟是联苯胺职业接触人群发生膀胱癌的主要危险因素,应以此确定高危人群;尿脱落细胞检查巴氏分级Ⅱ级及以上和QFIA阳性者,也应加强监护。
Objective To investigate the main risk factors of bladder cancer in workers exposed to benzidine in Tianjin to determine the risk groups. Methods A total of 106 bladder cancer patients in the exposed group of diphenylamine in Tianjin and 106 non-bladder cancer patients in the same period in the same period were enrolled into a case-control study. Single factor and multivariate non-conditional logistic regression analysis were used to screen the occupational population The main risk factors of bladder cancer, urinary exfoliative cells in the case group and the control group were also analyzed, providing reference for the early detection of occupational tumors and the identification of high-risk groups. Results The results of univariate and multivariate analysis showed that the risk factors of bladder cancer in exposed workers exposed to benzidine were the exposure to benzidine, professional seniority and smoking (P <0.05). The results of multivariate analysis showed that the main The risk factors were high exposure (OR = 4.752, 95% CI = 2.458-9.190), professional seniority (OR = 2.557,95% CI = 1.394-4.692), smoking (OR = 2.011, 95% CI = 1.020-3.966) . Pasteurization grade Ⅱ and above cases and quantitative fluorescence imaging analysis (QFIA) positive detection were higher than the control group, P <0.05. Conclusion High-level exposure, professional seniority over five years, smoking is a major risk factor for bladder cancer in exposed workers exposed to benzidine, and should be used to identify high-risk groups; urine exfoliated cells should be classified as grade Ⅱ or above and QFIA positive Should strengthen guardianship.