Schwartzbaum Judith, Jonsson Fredrik, Ahlbom Anders, Preston-Martin Susan, Lönn Stefan, Söderberg Karin C, Feychting Maria
Division of Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Int J Cancer. 2003 Sep 1;106(3):423-8. doi: 10.1002/ijc.11230.
An inverse association between self-reported allergies and glioma and meningioma risk, has been previously observed in case-control studies. Approximately 27% (median) of the information on both glioma and meningioma in these studies, however, is collected from proxy respondents. In fact, the odds ratios (OR) among previous brain tumor studies are inversely related to the proportion of proxy respondents (Pearson correlation coefficient = -0.94; 95% CI = -1.00 to -0.65); this correlation suggests bias. We therefore constructed 3 cohorts based on the Swedish Twin, Hospital Discharge, and Cancer Registries. In Cohorts I (14,535 people developed 37 gliomas and 41 meningiomas) and II (29,573 people developed 42 gliomas and 26 meningiomas) median time from self-report of allergies to brain tumor diagnosis was 15.4 years. Cohort III, which overlaps with Cohorts I and II (52,067 people developed 68 gliomas and 63 meningiomas), was linked to the Swedish Hospital Discharge Registry where pre-brain tumor immune-related discharge diagnoses were recorded. Allergies are inversely associated with glioma risk in Cohort I (Hazard ratio [HR] = 0.45; 95% CI = 0.19-1.07) and among high grade (III and IV, HR = 0.45; 95% CI = 0.11-1.92) but not low grade (I and II, HR = 2.60; 95% CI = 0.86-7.81) gliomas in Cohort II. In Cohort III, immune-related discharge diagnoses are also inversely associated with glioma (HR = 0.46; 95% CI = 0.14-1.49). There is no strong evidence against (and some for) the hypothesis that allergies reduce glioma risk.
在病例对照研究中，先前已观察到自我报告的过敏与胶质瘤和脑膜瘤风险之间存在负相关。然而，在这些研究中，关于胶质瘤和脑膜瘤的信息约有27%（中位数）是由代理受访者收集的。事实上，先前脑肿瘤研究中的优势比（OR）与代理受访者的比例呈负相关（皮尔逊相关系数=-0.94；95%置信区间=-1.00至-0.65）；这种相关性表明存在偏差。因此，我们根据瑞典双胞胎、医院出院和癌症登记处构建了3个队列。在队列I（14535人中有37例胶质瘤和41例脑膜瘤）和队列II（29573人中有42例胶质瘤和26例脑膜瘤）中，从自我报告过敏到脑肿瘤诊断的中位时间为15.4年。与队列I和队列II重叠的队列III（52067人中有68例胶质瘤和63例脑膜瘤）与瑞典医院出院登记处相关联，该登记处记录了脑肿瘤前免疫相关的出院诊断。在队列I中，过敏与胶质瘤风险呈负相关（风险比[HR]=0.45；95%置信区间=0.19-1.07），在队列II的高级别（III级和IV级，HR=0.45；95%置信区间=0.11-1.92）而非低级别（I级和II级，HR=2.60；95%置信区间=0.86-7.81）胶质瘤中也是如此。在队列III中，免疫相关的出院诊断也与胶质瘤呈负相关（HR=0.46；95%置信区间=0.14-1.49）。没有强有力的证据反对（且有一些证据支持）过敏会降低胶质瘤风险这一假设。
