Schlehofer B, Blettner M, Preston-Martin S, Niehoff D, Wahrendorf J, Arslan A, Ahlbom A, Choi W N, Giles G G, Howe G R, Little J, Ménégoz F, Ryan P
German Cancer Research Centre, Division of Epidemiology, Heidelberg.
Int J Cancer. 1999 Jul 19;82(2):155-60. doi: 10.1002/(sici)1097-0215(19990719)82:2<155::aid-ijc1>3.0.co;2-p.
In an international population-based case-control study carried out in 8 centres in 6 countries, we investigated the role of specific medical conditions in the aetiology of brain tumours in adults. Recruited were 1,178 glioma and 331 meningioma cases and 2,493 age- and gender-matched population controls. Only medical conditions occurring at least 2 years before brain tumour diagnosis were considered. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated using a conditional logistic regression model. Heterogeneity between centres was tested. No association between meningioma and previous medical conditions was observed. For glioma, there was an increased risk associated with epilepsy (RR = 6.55, 95% CI 3.40-12.63), but this was considerably weaker for epilepsy of more than 20 years duration. The risk remained elevated after adjustment for use of anti-epileptic drugs. There was a statistically significant inverse association between glioma and all allergic diseases combined (RR = 0.59, 95% CI 0.49-0.71); this was also observed for specific allergic conditions, namely, asthma and eczema. Subjects who reported a history of infectious diseases (e.g., colds, flu) showed a 30% reduction in risk (RR = 0.72, 95% CI 0.61-0.85). The decreased risks for glioma in subjects reporting a history of allergic conditions or infectious diseases may indicate an influence of immunological factors on the development of glioma. The association between glioma and epilepsy has to be interpreted cautiously and needs further investigation.
在一项基于国际人群的病例对照研究中，该研究在6个国家的8个中心开展，我们调查了特定疾病状况在成人大脑肿瘤病因学中的作用。招募了1178例胶质瘤患者和331例脑膜瘤患者以及2493名年龄和性别匹配的人群对照。仅考虑在脑肿瘤诊断前至少2年出现的疾病状况。使用条件逻辑回归模型估计相对风险（RRs）和95%置信区间（CIs）。对各中心之间的异质性进行了检验。未观察到脑膜瘤与既往疾病状况之间存在关联。对于胶质瘤，癫痫与之相关的风险增加（RR = 6.55，95% CI 3.40 - 12.63），但对于病程超过20年的癫痫，这种关联要弱得多。在调整抗癫痫药物使用情况后，风险仍然升高。胶质瘤与所有过敏性疾病合并存在统计学上显著的负相关（RR = 0.59，95% CI 0.49 - 0.71）；在特定过敏性疾病，即哮喘和湿疹中也观察到了这种情况。报告有传染病史（如感冒、流感）的受试者风险降低了30%（RR = 0.72，95% CI 0.61 - 0.85）。报告有过敏状况或传染病史的受试者患胶质瘤风险降低可能表明免疫因素对胶质瘤发展有影响。胶质瘤与癫痫之间的关联必须谨慎解读，需要进一步研究。
