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目的研究上海市区食管癌家族聚集性。方法用全人群病例┐对照研究方法，调查９０２例３０～７４岁食管癌新发病例，按频数配对随机配以１５５２例对照。结果食管癌家族史是食管癌的危险因素，男女相对危险度达到２～３左右，食管癌发病风险随着一级亲属患病人数的增多而增加（趋势检验Ｐ＜０．００１）。食管癌家族史调整人群归因危险度男性、女性分别为８．３％、９．２％。经过Ｌｉ┐Ｍａｎｔｅｌ┐Ｇａｒｔ法计算食管癌分离比为３．８３％（９５％ＣＩ＝３．１２％～４．４８％），提示属多基因遗传。根据Ｆａｌｃｏｎｅｒ方法，男性、女性遗传度分别为３３．２％±５．３％，３８．４％±３．６％，男女合并为３５．７％±２．２％。结论上海市区食管癌存在家族聚集现象。食管癌家族史增加食管癌发病风险。研究表明尽管遗传因素在食管癌的发生中起一定作用，但食管癌的发病风险主要来自环境因素。
Objective To study the family clustering of esophageal cancer in Shanghai. Methods A total population of patients was used as a control study to investigate 902 cases of new esophageal cancer from 30 to 74 years old and matched with 1552 controls according to frequency. Results The family history of esophageal cancer was a risk factor for esophageal cancer. The relative risk of men and women was about 2 to 3, and the risk of esophageal cancer increased as the number of first-degree relatives increased (trend test P<0.001). The family histories of esophageal cancer adjusted the population attributable risk of men and women were 8.3% and 9.2%, respectively. After Li┐Mantel┐Gart method, the separation ratio of esophageal cancer was calculated to be 3.83% (95%CI=3.12%~4.48%), suggesting a genetic polygene. According to the Falconer method, the heritability of males and females was 33.2% ± 5.3% and 38.4% ± 3.6%, respectively, and the male and female combined were 35.7% ± 2.2%. Conclusion There is a family clustering phenomenon in esophageal cancer in Shanghai. A family history of esophageal cancer increases the risk of esophageal cancer. Studies have shown that although genetic factors play a role in the development of esophageal cancer, the risk of esophageal cancer mainly comes from environmental factors.