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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳建仁,鄭玉娟 | |
| dc.contributor.author | Chi-Chen Lin | en |
| dc.contributor.author | 林志真 | zh_TW |
| dc.date.accessioned | 2021-06-13T05:58:43Z | - |
| dc.date.available | 2007-07-31 | |
| dc.date.copyright | 2006-07-31 | |
| dc.date.issued | 2006 | |
| dc.date.submitted | 2006-06-27 | |
| dc.identifier.citation | 1. 行政院衛生署, 1982-2004年癌症死因之統計資料.
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/34221 | - |
| dc.description.abstract | 肺癌及乳癌為台灣女性重要之癌症。從流行病學的研究中發現抽煙雖被廣泛認為是導致肺癌的主要原因，但台灣女性抽煙人口低於10%；已知與乳癌相關的危險因子如家族史、肥胖、荷爾蒙等，其可歸因百分比也僅佔20-40%，顯示仍有其他危險因子參與台灣女性肺癌及乳癌的發生。人類乳突病毒(human papillomavirus, HPV)感染不僅是子宮頸癌的必要因子，以往亦曾有病例系列及病例對照研究指出與肺癌與乳癌的相關性，但橫斷性研究無法提供明確的因果時序性，故本研究期望透過前瞻性長期追蹤之世代研究建立良好的時序性來探討人類乳突病毒感染與否對台灣婦女肺癌及乳癌發生之可能角色。
本研究係以1991年居住於台灣七個鄉鎮市接受子宮頸抹片檢查及子宮頸細胞檢體採集之10615名婦女(30-64歲)為研究對象，利用聚合酶素連鎖反應及HPV基因晶片檢測子宮頸細胞中HPV DNA並加以定型；新發之肺癌及乳癌個案則係與癌症登記檔、死亡檔及重大傷病檔連結獲得。統計分析採用Cox 比例危險模式(Cox proportional hazards model)計算相對危險性及95%信賴區間。 研究結果顯示在調整其他危險因子後，HPV11、74、CP8304、MM4、16、45、35、43、51及MM8等型別可能為致肺癌高危險型別，其罹患肺癌之危險性(RR)皆高於2倍，感染任一上述型別者發生肺癌之危險性為2.7倍(95%CI:1.5- 5.1)；另一方面，致乳癌之高危險型別則為HPV39、42、CP8304、51、CP8061、32、55及66等型(RR>=2.0)，感染其中任一型別亦有2.7倍(95%CI:1.5-4.7)的高風險。在排除子宮頸異常之可能干擾因素後，罹患肺癌及乳癌的危險性皆約為3倍。進一步針對女性肺腺癌之分析發現，感染HPV11、74、CP8304、MM4、45及35等之任何一型，其罹患肺腺癌之危險性高達5.4倍。 本研究發現許多不同人類乳突病毒型別的感染，可能與台灣女性乳癌及肺癌，特別是肺腺癌的發生有關。 | zh_TW |
| dc.description.abstract | Introduction: Cancers of lung and breast were major threats to women’ lives in Taiwan. Less than 50% of risk could be attributed to major risk factors, such as smoking to lung cancer as well as family history, obesity and female hormone to breast cancer. Since human papillomavirus (HPV) was ever proposed a positive association with lung/breast cancer by few cross-sectional case-series or case-control studies. For better temporality in causal inference, a long-term follow-up study using a community-based female cohort was subject of the role of HPV infection in cancer development of lung and breast.
Method: A prospective cohort study of 10615 female participants (aged 30-64 years), who received examination of Pap smear and cervical cell collection at enrollment, recruited to a community-based cancer screening program in 1991-1992. HPV DNA and genotypes were performed by polymerase chain reactions and HPV Blot. Cox proportional hazards model was used to estimate HPV type-specific risk ratio (RR) and their confidence intervals (CIs) of lung/breast cancer with multiple adjustment. Result: HPV types of 11, 74, CP8304, MM4, 16, 45, 35, 43, 51 and MM8 were suggested as high-risk types (RR>=2) for lung cancer. The adjusted RR was 2.7 (95%CI:1.5-5.1) for women infected with any one of these types to develop lung cancer during follow-up. Considering high-risk types for breast cancer (HPV39, 42, CP8304, 51, CP8061, 55 and 66), its RR was 2.7(95%CI:1.5-4.7). Consistently, the RRs were about 3-fold for both sites of cancer while subjects with abnormal cervix further excluded. We also found that HPV 11, 74, CP8304, MM4, 45 and 35 were strongly associated with lung adenocarcinoma, and its RR (95% C.I.) was 5.4(2.1-13.6). | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T05:58:43Z (GMT). No. of bitstreams: 1 ntu-95-R93842014-1.pdf: 437040 bytes, checksum: 0c0e9f0d6992cde61b80d2859e912315 (MD5) Previous issue date: 2006 | en |
| dc.description.tableofcontents | 致謝……………………………………………………………………..第2頁
中文摘要………………………………………………………………..第3頁 英文摘要………………………………………………………………..第4頁 目錄……………………………………………………………………..第5頁 圖表目錄………………………………………………………………..第7頁 第一章 研究背景與動機……………………………………………第8頁 第二章 文獻回顧……………………………………………………第9頁 第一節 人類乳突病毒……………………………………………第9頁 第二節 肺癌………………………………………………………第10頁 第三節 乳癌………………………………………………………第14頁 第三章 研究目的、研究設計、研究族群、資料收集及統計方法…第20頁 第一節 研究目的…………………………………………………第20頁 第二節 研究設計…………………………………………………第21頁 第三節 研究族群…………………………………………………第21頁 第四節 資料收集…………………………………………………第23頁 第五節 統計方法…………………………………………………第24頁 第四章 研究結果……………………………………………………第25頁 第一節 子宮頸細胞之人類乳突病毒型別感染與女性肺癌及乳癌的相關性……第25頁 第二節 子宮頸細胞之人類乳突病毒持續感染與台灣女性肺癌及乳癌的相關……第28頁 第三節 子宮頸狀態異常是否會影響人類乳突病毒與台灣女性肺癌及乳癌之相關…第31頁 第四節 子宮頸細胞之人類乳突病毒感染與不同肺癌腫瘤分類的相關性…第33頁 第五節 子宮頸細胞之人類乳突病毒感染對於肺癌及乳癌所扮演的是短期或長期的生物學標記…第35頁 第五章 討論……………………………………………………………第36頁 第一節 子宮頸細胞之人類乳突病毒與女性肺癌及乳癌的相關性……第36頁 第二節 子宮頸狀態異常是否會影響人類乳突病毒與台灣女性肺癌及乳癌之相關…第39頁 第三節 子宮頸細胞之人類乳突病毒感染與不同肺癌腫瘤分類的相關性…第43頁 第四節 子宮頸細胞之人類乳突病毒感染對於肺癌及乳癌所扮演的是短期或長期的生物學標記…第45頁 第五節 子宮頸人類乳突病毒感染至肺癌及乳癌之可能途徑……第46頁 第六節 人類乳突病毒感染與其他內臟癌症之相關………………第47頁 第六章 結論……………………………………………………………第48頁 第七章 研究限制………………………………………………………第49頁 參考資料…………………………………………………………………第50頁 圖表目錄 表1 人類乳突病毒與肺癌之病例系列研究 …………… 第56頁 表2 人類乳突病毒與肺癌之病例對照研究 …………… 第58頁 表3 人類乳突病毒與乳癌之病例系列研究 …………… 第59頁 表4 人類乳突病毒與乳癌之病例對照研究 …………… 第60頁 圖1 研究對象流程圖 …………… 第61頁 表5 研究世代及肺癌個案之人類乳突病毒感染型別分佈 …………… 第62頁 表6 人口學特性及常見危險因子與肺癌之相關 …………… 第63頁 表7 研究世代及乳癌個案之人類乳突病毒感染型別之分佈 …………… 第65頁 表8 人口學特性及常見危險因子與乳癌之相關 …………… 第66頁 表9 子宮頸之不同型別人類乳突病毒感染與肺癌及乳癌之相關性分析 …………… 第69頁 表10 接受追蹤檢查之6839名婦女之人口學特性及常見危險因子與肺癌之相關 …………… 第72頁 表11 接受追蹤檢查之6832名婦女之人口學特性及常見危險因子與乳癌之相關 …………… 第74頁 表12 子宮頸人類乳突病毒持續感染與肺癌及乳癌之相關 …………… 第76頁 表13 排除基線子宮頸抹片異常之10257名婦女的人口學特性及常見危險因子與肺癌之相關 …………… 第77頁 表14 排除基線子宮頸抹片異常之10241名婦女的人口學特性及常見危險因子與乳癌之相關 …………… 第79頁 表15 排除基線子宮頸抹片異常之婦女的子宮頸人類乳突病毒感染與肺癌及乳癌之相關性 …………… 第82頁 表16 人口學特性及常見危險因子與肺腺癌之相關 …………… 第85頁 表17 人口學特性及常見危險因子與其他組織型態肺癌之相關 …………… 第87頁 表18 子宮頸人類乳突病毒感染與肺腺癌及其他組織型態肺癌之相關 …………… 第89頁 表19 子宮頸細胞之人類乳突病毒感染對於肺癌所扮演的為短期或長期的生物學標記 …………… 第91頁 表20 子宮頸細胞之人類乳突病毒感染對於乳癌所扮演的為短期或長期的生物學標記 …………… 第91頁 | |
| dc.language.iso | zh-TW | |
| dc.subject | 人類乳突病毒 | zh_TW |
| dc.subject | 乳癌 | zh_TW |
| dc.subject | 肺癌 | zh_TW |
| dc.subject | Human papillomavirus | en |
| dc.subject | Breast cancer | en |
| dc.subject | Lung cancer | en |
| dc.title | 人類乳突病毒感染與女性肺癌及乳癌之分子流行病學研究 | zh_TW |
| dc.title | Associations between Human Papillomavirus and Female Lung and Breast Cancers in Taiwan | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 94-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 李文宗,孫建安,沈志陽 | |
| dc.subject.keyword | 人類乳突病毒,肺癌,乳癌, | zh_TW |
| dc.subject.keyword | Human papillomavirus,Lung cancer,Breast cancer, | en |
| dc.relation.page | 91 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2006-06-28 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 流行病學研究所 | zh_TW |
| 顯示於系所單位： | 流行病學與預防醫學研究所 | |
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