検死研究における肺がんリスクの活性・受動的喫煙および病理的指標
D Trichopoulos1, F Mollo, L Tomatis
1Department of Epidemiology, Harvard School of Public Health, Boston, Mass 02115.
JAMA
|October 7, 1992
まとめ
ギリシャでのこの解剖研究では,上皮の損傷によって示される被動喫煙が肺がんのリスクと関連していることが判明しました. 結果は,喫煙者と結婚した女性では病変がより多く示され,被動喫煙の証拠を裏付けました.
科学分野:
- 肺病理学と環境発がん.
- 肺がんと喫煙関連疾患の流行病学.
背景:
- 流行病学的な研究は,非自発的な喫煙 (受動的喫煙) と肺がんとの関連を示唆しています.
- 以前の研究におけるバイアスの懸念は依然として存在し,代替研究方法が必要となっている.
- 解剖に基づく研究は稀であり,肺がん発生における被動喫煙の役割を特に調査した研究はありません.
研究 の 目的:
- 肺がん発生における被動喫煙の役割に関する解剖に基づく調査を行うこと.
- 肺がんリスクの潜在的な指標として,肺組織における上皮の変化を調べる.
- 喫煙習慣,受動的煙への曝露,および肺の標本における病理学的発見との関連を調べる.
主な方法:
- 肺のサンプルは,ギリシャのアテネの400件の解剖 (年齢35歳以上) から採取され,呼吸道疾患やがんによる死亡は除外された.
- 基礎細胞増殖および転形成 (EPPL) のような病変を検出するために,支柱膜上皮質の組織病理学的検査.
- 206人の被験者の近親とのインタビューは,死者および配偶者の喫煙習慣に関するデータを提供した;インタビュー者は,病理学的結果に盲目であった.
主要な成果:
- 皮質,おそらくがん前,病変 (EPPL) は,非喫煙者と比較して現在の喫煙者において有意に高かった.
- EPPL値は,非喫煙者と結婚した非喫煙者の女性よりも,喫煙者と結婚した非喫煙者の女性で著しく高かった.
- Reid Indexは,喫煙者および都市部住民の値が上昇する傾向を示したが,統計的に有意な違いはなかった.
結論:
- この発見は,受動喫煙と肺がんのリスクとの関連を裏付けている.
- この解剖に基づく研究は,既存の疫学データを補完する新しい証拠を提供します.
- パッシーブ・スモーク曝露と肺がん発生を結びつけるメカニズムを完全に解明するために,さらなる研究が必要である.
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