Mellemkjaer L, Alexander F, Olsen J H
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen.
Br J Cancer. 2000 Apr;82(7):1353-7. doi: 10.1054/bjoc.1999.1104.
Many different aetiologies for childhood cancer have been suggested, but few are well established. One is that parental autoimmune disease is linked with susceptibility for haematopoietic malignancies in their offspring during childhood. The present study is the first to investigate this hypothesis using a follow-up design. A cohort of 53,811 children of more than 36,000 patients diagnosed with a systemic, organ-specific or suspected autoimmune disease were followed up for cancer incidence in the Danish Cancer Registry during 1968-1993. The parents were identified through the National Registry of Patients, while their children were traced in the Central Population Register. Cancer incidence among the offspring was compared with that in the corresponding childhood population of Denmark. In total, 115 cancers were observed among children aged 0-19 years, yielding a non-significant standardized incidence ratio of 1.07. Lymphomas contributed 21 cases to the overall number of tumours, 60% more than expected (95% confidence interval (CI) 1.0-2.4); leukaemia contributed 37 cases representing an excess of 30% (95% CI 0.9-1.8). Our results give some support to the hypothesis that parental autoimmune disease is associated with childhood lymphoma and leukaemia.
关于儿童癌症的病因,人们提出了许多不同的观点,但鲜有定论。其中一种观点认为,父母自身免疫性疾病与子女在儿童期患血液系统恶性肿瘤的易感性有关。本研究首次采用随访设计对这一假说进行调查。在1968年至1993年期间,丹麦癌症登记处对超过36000名被诊断患有全身性、器官特异性或疑似自身免疫性疾病的患者的53811名子女进行了癌症发病率随访。通过国家患者登记处确定父母身份,同时在中央人口登记处追踪他们的子女。将这些子女的癌症发病率与丹麦相应儿童群体的发病率进行比较。在0至19岁的儿童中,共观察到115例癌症,标准化发病率为1.07,无统计学意义。淋巴瘤占肿瘤总数的21例,比预期多60%(95%置信区间(CI)1.0-2.4);白血病占37例,超额30%(95%CI 0.9-1.8)。我们的结果为父母自身免疫性疾病与儿童淋巴瘤和白血病有关这一假说提供了一些支持。