Hjalgrim Henrik, Rostgaard Klaus, Askling Johan, Madsen Mette, Storm Hans H, Rabkin Charles S, Melbye Mads
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark.
J Natl Cancer Inst. 2002 May 1;94(9):678-81. doi: 10.1093/jnci/94.9.678.
Young adults with a history of Epstein-Barr virus (EBV)-related infectious mononucleosis have an increased risk for Hodgkin's lymphoma. EBV is detected in Hodgkin's lymphoma Reed-Sternberg cells from some patients, but in young adult patients, it is detected at a relatively low frequency in these cells. Hodgkin's lymphoma and infectious mononucleosis are both associated with high social class, and unknown confounding factors that are also associated with socioeconomic status might explain or contribute to the apparent association between these diseases. To indirectly assess the importance of socioeconomic status on the association between these diseases, we determined the risk for hematopoietic and lymphatic cancers in first-degree relatives of patients with confirmed EBV-related infectious mononucleosis.
We identified parents, siblings, and offspring of 17,045 persons with serologically confirmed EBV-related infectious mononucleosis. Subjects in these cohorts were linked with the population-based Danish Cancer Register to identify those developing hematopoietic/lymphatic cancers after the index patient was diagnosed with infectious mononucleosis. The relative risk for cancer in the infectious mononucleosis family members was expressed as standardized incidence ratios (SIRs; i.e., the ratio between the number of cancers observed and the number of cancers expected, obtained from age-specific, sex-specific, and period-specific incidence rates).
We identified 8052 parents, 5264 siblings, and 28,605 offspring of patients with EBV-related infectious mononucleosis who were followed for a total of 892,213 person-years at risk. The risk for Hodgkin's lymphoma was unaltered in the combined group of first-degree relatives of these patients (SIR = 0.99; 95% confidence interval [95% CI] = 0.62 to 1.59; number of cases [n] = 17), in the group of parents (SIR = 0.83; 95% CI = 0.31 to 2.22; n = 4), in the group of siblings (SIR = 0.96; 95% CI = 0.31 to 2.97; n = 3), and in the group of offspring (SIR = 1.08; 95% CI = 0.58 to 2.02; n = 10).
The unremarkable risk for Hodgkin's lymphoma in family members of patients with EBV-related infectious mononucleosis indicates that socioeconomic confounding is an unlikely explanation for the association between EBV-related infectious mononucleosis and Hodgkin's lymphoma.
有EB病毒（EBV）相关传染性单核细胞增多症病史的年轻人患霍奇金淋巴瘤的风险增加。在一些患者的霍奇金淋巴瘤里德-斯特恩伯格细胞中可检测到EBV，但在年轻成年患者中，在这些细胞中的检测频率相对较低。霍奇金淋巴瘤和传染性单核细胞增多症都与高社会阶层有关，与社会经济地位也相关的未知混杂因素可能解释或促成了这些疾病之间明显的关联。为了间接评估社会经济地位对这些疾病之间关联的重要性，我们确定了确诊为EBV相关传染性单核细胞增多症患者的一级亲属患造血和淋巴系统癌症的风险。
我们确定了17045名血清学确诊为EBV相关传染性单核细胞增多症患者的父母、兄弟姐妹和子女。这些队列中的受试者与基于人群的丹麦癌症登记处相联系，以识别在索引患者被诊断为传染性单核细胞增多症后发生造血/淋巴系统癌症的人。传染性单核细胞增多症家庭成员患癌症的相对风险以标准化发病比（SIRs；即观察到的癌症病例数与预期癌症病例数之比，根据年龄、性别和时期特异性发病率得出）表示。
我们确定了8052名父母、5264名兄弟姐妹和28605名EBV相关传染性单核细胞增多症患者的子女，他们总共随访了892213人年的风险期。这些患者的一级亲属合并组中霍奇金淋巴瘤的风险未改变（SIR = 0.99；95%置信区间[95%CI] = 0.62至1.59；病例数[n] = 17），父母组中（SIR = 0.83；95%CI = 0.31至2.22；n = 4），兄弟姐妹组中（SIR = 0.96；95%CI = 0.31至2.97；n = 3），以及子女组中（SIR = 1.08；95%CI = 0.58至2.02；n = 10）。
EBV相关传染性单核细胞增多症患者家庭成员中霍奇金淋巴瘤风险无显著变化，这表明社会经济混杂不太可能解释EBV相关传染性单核细胞增多症与霍奇金淋巴瘤之间的关联。
