Grulich Andrew Edwin, Vajdic Claire Melissa, Kaldor John Martin, Hughes Ann Maree, Kricker Anne, Fritschi Lin, Turner Jennifer Jane, Milliken Sam, Benke Geza, Armstrong Bruce Konrad
National Centre in HIV Epidemiology and Clinical Research, University of NSW, Sydney, Australia.
J Natl Cancer Inst. 2005 Apr 20;97(8):587-94. doi: 10.1093/jnci/dji098.
Immune deficiency is a strong risk factor for non-Hodgkin lymphoma (NHL), but whether or not other forms of immune dysregulation are associated with NHL risk is unknown. We investigated associations between atopy, which is associated with a Th2-dominant immune response, and NHL risk. Because late birth order and childhood crowding are inversely associated with atopy, we also investigated their associations with NHL risk.
We carried out a population-based case-control study among adults aged 20-74 years in New South Wales and the Australian Capital Territory, Australia. NHL patients without clinically apparent immune deficiency (N = 704) were selected from a cancer registry, and control subjects (N = 694) were randomly selected from state electoral rolls and frequency-matched to case patients by age, sex, and area of residence. Birth order, childhood crowding, and history of atopic conditions (hay fever, asthma, eczema, and specific allergies) were assessed by questionnaire and interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from logistic regression models that included the matching variables as covariates.
The odds ratios for developing NHL were 0.52 (95% CI = 0.32 to 0.84) for only children, 0.55 (95% CI = 0.40 to 0.75) for first-born children, 0.70 (95% CI = 0.51 to 0.96) for second-born children, and 0.81 (0.57 to 1.14) for third-born children (all compared with fourth- or later-born children) (P(trend)<.001). Indicators of crowding in later childhood, such as sharing a bed or bedroom, were not associated with NHL risk. A history of atopic conditions was associated with a reduced risk of NHL; this reduction was statistically significant for hay fever (OR = 0.65, 95% CI = 0.52 to 0.82) and food allergies (OR = 0.29, 95% CI = 0.20 to 0.42).
Early birth order and its immunologic consequence, a Th2-dominated immune response, as reflected by a history of atopic disease, are associated with a reduced risk of NHL.
免疫缺陷是非霍奇金淋巴瘤(NHL)的一个重要危险因素,但其他形式的免疫失调是否与NHL风险相关尚不清楚。我们研究了与以Th2为主导的免疫反应相关的特应性与NHL风险之间的关联。由于出生顺序靠后和童年时期拥挤与特应性呈负相关,我们还研究了它们与NHL风险的关联。
我们在澳大利亚新南威尔士州和澳大利亚首都直辖区对20至74岁的成年人进行了一项基于人群的病例对照研究。从癌症登记处选取无临床明显免疫缺陷的NHL患者(N = 704),并从州选举名册中随机选取对照对象(N = 694),并按年龄、性别和居住地区与病例患者进行频率匹配。通过问卷调查和访谈评估出生顺序、童年时期的拥挤情况以及特应性疾病史(花粉热、哮喘、湿疹和特定过敏)。根据包含匹配变量作为协变量的逻辑回归模型计算比值比(OR)和95%置信区间(CI)。
独生子女患NHL的比值比为0.52(95%CI = 0.32至0.84),头胎子女为0.55(95%CI = 0.40至0.75),二胎子女为0.70(95%CI = 0.51至0.96),三胎子女为0.81(0.57至1.14)(均与四胎或更高胎次的子女相比)(P趋势<.001)。童年后期拥挤的指标,如共用一张床或一间卧室,与NHL风险无关。特应性疾病史与NHL风险降低相关;花粉热(OR = 0.65,95%CI = 0.52至0.82)和食物过敏(OR = 0.29,95%CI = 0.20至0.42)的这种降低具有统计学意义。
如特应性疾病史所反映的,出生顺序靠前及其免疫后果,即以Th2为主导的免疫反应,与NHL风险降低相关。