Jackson L A, Wang S P, Nazar-Stewart V, Grayston J T, Vaughan T L
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, USA.
Cancer Epidemiol Biomarkers Prev. 2000 Nov;9(11):1263-6.
Chlamydia pneumoniae is a common respiratory pathogen that has also been associated with risk for chronic diseases, including atherosclerotic cardiovascular disease. Two recent studies have reported an association between serological evidence of past infection with the organism and lung cancer. To further evaluate this association, we conducted a case-control study among a subgroup of white male smokers identified for a population-based case-control study of lung cancer in western Washington between 1993 and 1995. Serum specimens obtained at study enrollment from 143 cases and 147 controls were tested for C. pneumoniae IgG, IgM, and IgA antibodies. In multivariate analysis controlling for smoking variables and educational status, IgA antibody titer 216 was independently associated with risk of lung cancer among subjects <60 years of age [odds ratio (OR), 2.67; 95% confidence interval (CI), 1.21-5.89] but not among older subjects (OR, 0.69; 95% CI, 0.34-1.43). Among subjects <60 years of age, there was suggestive evidence of a stronger association among current smokers (OR 4.31; 95% CI, 1.36-13.68) than former smokers (OR 1.50; 95% CI, 0.48-4.75; P for interaction term, 0.26). Additional studies, including prospective serological evaluations, are needed to further assess the possible significance of this association.
肺炎衣原体是一种常见的呼吸道病原体，也与包括动脉粥样硬化性心血管疾病在内的慢性疾病风险相关。最近的两项研究报告了既往感染该病原体的血清学证据与肺癌之间的关联。为了进一步评估这种关联，我们在1993年至1995年期间于华盛顿州西部开展的一项基于人群的肺癌病例对照研究中，对一组白人男性吸烟者亚组进行了病例对照研究。在研究入组时从143例病例和147例对照中获取的血清标本检测了肺炎衣原体IgG、IgM和IgA抗体。在对吸烟变量和教育程度进行控制的多变量分析中，IgA抗体滴度≥1:64与<60岁受试者的肺癌风险独立相关[比值比（OR），2.67；95%置信区间（CI），1.21 - 5.89]，但在年龄较大的受试者中无此关联（OR，0.69；95% CI，0.34 - 1.43）。在<60岁的受试者中，有提示性证据表明当前吸烟者（OR 4.31；95% CI，1.36 - 13.68）比既往吸烟者（OR 1.50；95% CI，0.48 - 4.75；交互项P值，0.26）之间的关联更强。需要开展更多研究，包括前瞻性血清学评估，以进一步评估这种关联的可能意义。
