Wrensch Margaret, Weinberg Adriana, Wiencke John, Miike Rei, Sison Jennette, Wiemels Joseph, Barger Geoffrey, DeLorenze Gerald, Aldape Kenneth, Kelsey Karl
Department of Neurological Surgery, School of Medicine, University of California, San Francisco, CA 94102, USA.
Am J Epidemiol. 2005 May 15;161(10):929-38. doi: 10.1093/aje/kwi119.
Whether viruses or immunologic factors might cause or prevent human brain cancer is of interest. Statistically significant inverse associations of adult glioma with history of chickenpox and immunoglobulin G antibodies to varicella-zoster virus have been reported. The authors evaluate associations of immunoglobulin G antibodies to varicella-zoster virus and three other herpesviruses among 229 adults with glioma and 289 controls in the San Francisco Bay Area Adult Glioma Study (1997-2000). Cases were less likely than controls to report a history of chickenpox (for self-reported cases vs. controls: the age-, gender-, and ethnicity-adjusted odds ratio = 0.59, 95% confidence interval: 0.40, 0.86), and they also had lower levels of immunoglobulin G to varicella-zoster virus (for being in the highest quartile vs. the lowest quartile: the age-, gender-, and ethnicity-adjusted odds ratio = 0.41, 95% confidence interval: 0.24, 0.70). The inverse association with anti-varicella-zoster virus immunoglobulin G was most marked for glioblastoma multiforme cases versus controls and was only somewhat attenuated by excluding subjects taking high-dose steroids and other medications. Cases and controls did not differ notably for positivity to three other herpesviruses, Epstein-Barr virus, cytomegalovirus, and herpes simplex virus. Cohort studies may help to clarify the nature of the association between immunity to and/or clinical manifestations of varicella-zoster virus and glioblastoma.
病毒或免疫因素是否会引发或预防人类脑癌备受关注。据报道,成人胶质瘤与水痘病史以及水痘 - 带状疱疹病毒免疫球蛋白G抗体之间存在具有统计学意义的负相关。在旧金山湾区成人胶质瘤研究(1997 - 2000年)中,作者评估了229例成人胶质瘤患者和289例对照者体内水痘 - 带状疱疹病毒以及其他三种疱疹病毒的免疫球蛋白G抗体之间的关联。病例报告有水痘病史的可能性低于对照者(自我报告的病例与对照者相比:年龄、性别和种族调整后的优势比 = 0.59,95%置信区间:0.40,0.86),并且他们体内水痘 - 带状疱疹病毒的免疫球蛋白G水平也较低(处于最高四分位数与最低四分位数相比:年龄、性别和种族调整后的优势比 = 0.41,95%置信区间:0.24,0.70)。多形性胶质母细胞瘤病例与对照者相比,抗水痘 - 带状疱疹病毒免疫球蛋白G的负相关最为明显,并且通过排除服用高剂量类固醇和其他药物的受试者,这种相关性仅略有减弱。病例和对照者在另外三种疱疹病毒,即爱泼斯坦 - 巴尔病毒(EB病毒)、巨细胞病毒和单纯疱疹病毒的阳性率方面没有显著差异。队列研究可能有助于阐明水痘 - 带状疱疹病毒免疫和/或临床表现与胶质母细胞瘤之间关联的性质。