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[目的]应用主成分改进的Logistic回归模型评估非病毒危险因素在中国南方鼻咽癌发病中的作用。[方法]采用病例-对照研究方法,选择来自梧州市和苍梧县及其周边两广高发市县的经病理学确诊的鼻咽癌病人1010例,以及正常人对照1009例。病例与对照的EB病毒IgA/VCA检测均为阳性。对有关暴露因素进行单因素及多因素逐步非条件Logistic回归分析,以主成分改进的Logistic回归分析解决共线性问题。[结果]应用主成分分析改进后的Logistic回归模型拟合数据,不仅各回归系数的标准误均有减小,而且有更多的因素被选入模型。研究结果显示有鼻咽癌家族史及鼻咽癌一级亲属的EB病毒IgA/VCA阳性个体患鼻咽癌的风险会升高3.04倍、3.71倍。食用咸鱼及熏肉、经常接触柴火及有机溶剂、较早年龄开始吸烟会显著增加患鼻咽癌的风险,其OR值分别为1.88、1.97、3.99、3.01、2.04。[结论]在调整EB病毒感染状态因素后,主成分改进的Logistic回归分析结果证实在南方高发区鼻咽癌家族史、食用咸鱼及熏肉、接触柴火及有机溶剂、吸烟仍然是鼻咽癌的非病毒危险因素。
[Objective] To evaluate the role of non-viral risk factors in the pathogenesis of nasopharyngeal carcinoma in southern China by using the principal component modified Logistic regression model. [Methods] A case-control study was conducted in 1010 pathologically-confirmed NPC patients and 1009 normal controls from Wuzhou City and Cangwu County and its surrounding counties. Epstein-Barr virus IgA / VCA test was positive in both cases and controls. The exposure factors were analyzed by single factor and multi-factor stepwise non-conditional logistic regression, and the Logistic regression analysis was used to solve the colinearity problem. [Results] Using the Logistic regression model modified by principal component analysis to fit the data, not only the standard error of each regression coefficient decreased, but also more factors were selected into the model. The results show that the family history of nasopharyngeal carcinoma and NPC relatives of Epstein-Barr virus IgA / VCA-positive individuals suffering from nasopharyngeal cancer risk increased by 3.04 times, 3.71 times. Consumption of salted fish and bacon, frequent exposure to firewood and organic solvents, smoking started earlier age significantly increased the risk of suffering from nasopharyngeal carcinoma, the OR values were 1.88,1.97,3.99,3.01,2.04. [Conclusion] Logistic regression analysis of principal components improved after adjusting for Epstein-Barr virus status confirmed the family history of nasopharyngeal carcinoma in high incidence areas of the South, consumption of salted fish and bacon, exposure to firewood and organic solvents, and smoking remained nasopharyngeal carcinoma Of non-viral risk factors.