Baldwin Rachel Tobias, Preston-Martin Susan
Department of Family Medicine, Division of Preventive Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA 90095, USA.
Toxicol Appl Pharmacol. 2004 Sep 1;199(2):118-31. doi: 10.1016/j.taap.2003.12.029.
Malignant brain tumors are the leading cause of cancer death among children and the second most common type of pediatric cancer. Despite several decades of epidemiologic investigation, the etiology of childhood brain tumors (CBT) is still largely unknown. A few genetic syndromes and ionizing radiation are established risk factors. Many environmental exposures and infectious agents have been suspected of playing a role in the development of CBT. This review, based on a search of the medical literature through August 2003, summarizes the epidemiologic evidence to date. The types of exposures discussed include ionizing radiation, N-nitroso compounds (NOC), pesticides, tobacco smoke, electromagnetic frequencies (EMF), infectious agents, medications, and parental occupational exposures. We have chosen to focus on perinatal exposures and review some of the recent evidence indicating that such exposures may play a significant role in the causation of CBT. The scientific community is rapidly learning more about the molecular mechanisms by which carcinogenesis occurs and how the brain develops. We believe that advances in genetic and molecular biologic technology, including improved histologic subtyping of tumors, will be of huge importance in the future of epidemiologic research and will lead to a more comprehensive understanding of CBT etiology. We discuss some of the early findings using these technologies.
恶性脑肿瘤是儿童癌症死亡的主要原因，也是儿童癌症中第二常见的类型。尽管经过了几十年的流行病学调查，但儿童脑肿瘤（CBT）的病因仍 largely 未知。一些遗传综合征和电离辐射是已确定的危险因素。许多环境暴露因素和感染因子被怀疑在 CBT 的发生发展中起作用。本综述基于截至2003年8月对医学文献的检索，总结了迄今为止的流行病学证据。所讨论的暴露类型包括电离辐射、N-亚硝基化合物（NOC）、农药、烟草烟雾、电磁频率（EMF）、感染因子、药物以及父母的职业暴露。我们选择重点关注围产期暴露，并回顾一些近期证据，这些证据表明此类暴露可能在 CBT 的病因中起重要作用。科学界正在迅速了解更多关于致癌发生的分子机制以及大脑如何发育的知识。我们相信，包括改进肿瘤组织学亚型分类在内的遗传和分子生物学技术的进步，在未来的流行病学研究中将具有极其重要的意义，并将导致对 CBT 病因有更全面的理解。我们讨论了使用这些技术的一些早期发现。
