Schoemaker M J, Swerdlow A J, Auvinen A, Christensen H C, Feychting M, Johansen C, Klaeboe L, Lönn S, Salminen T, Tynes T
Section of Epidemiology, Institute of Cancer Research, Sutton, United Kingdom.
Int J Cancer. 2007 Jan 1;120(1):103-10. doi: 10.1002/ijc.22272.
Acoustic neuroma (vestibular schwannoma) is a benign tumor of the vestibulocochlear nerve. Its recorded incidence is increasing but risk factors for this tumor have scarcely been investigated. We conducted a population-based case-control study of risk factors for acoustic neuroma in the UK and Nordic countries, including 563 cases and 2,703 controls. Tumor risk was analyzed in relation to medical history and cigarette smoking. Risk of acoustic neuroma was significantly raised in parous compared with nulliparous women (OR = 1.7, 95% CI: 1.1-2.6), but was not related to age at first birth or number of children. Risk was not associated with a history of allergic disease, past head injury, past diagnosis of a neoplasm or birth characteristics, but was significantly raised for past diagnosis of epilepsy (OR = 2.5, 95% CI: 1.3-4.9). Tumor risk was significantly reduced in subjects who had ever regularly smoked cigarettes (OR = 0.7, 95% CI: 0.6-0.9), but the reduction applied only to current smokers (OR = 0.5, 95% CI: 0.4-0.6), not ex-smokers (OR = 1.0, 95% CI: 0.8-1.3). The reduced risk of acoustic neuroma in smokers and raised risk in parous women might relate to sex hormone levels, or smoking might suppress tumor growth, but effects of parity and smoking on timing of diagnosis of the tumor are also a potential explanation. The raised risk in relation to past diagnosis of epilepsy might be a surveillance artefact or imply that epilepsy and/or antiepileptic medication use predispose to acoustic neuroma. These findings need replication by other studies and possible mechanisms need to be clarified.
听神经瘤（前庭神经鞘瘤）是一种起源于前庭蜗神经的良性肿瘤。其记录的发病率呈上升趋势，但该肿瘤的危险因素几乎未得到研究。我们在英国和北欧国家开展了一项基于人群的听神经瘤危险因素病例对照研究，包括563例病例和2703例对照。分析了肿瘤风险与病史和吸烟情况的关系。与未生育女性相比，经产妇患听神经瘤的风险显著升高（比值比[OR]=1.7，95%置信区间[CI]：1.1 - 2.6），但与初产年龄或子女数量无关。风险与过敏性疾病史、既往头部损伤、既往肿瘤诊断或出生特征无关，但既往癫痫诊断会使风险显著升高（OR = 2.5，95% CI：1.3 - 4.9）。曾经经常吸烟的受试者肿瘤风险显著降低（OR = 0.7，95% CI：0.6 - 0.9），但这种降低仅适用于当前吸烟者（OR = 0.5，95% CI：0.4 - 0.6），不适用于既往吸烟者（OR = 1.0，95% CI：0.8 - 1.3）。吸烟者听神经瘤风险降低以及经产妇风险升高可能与性激素水平有关，或者吸烟可能抑制肿瘤生长，但生育状况和吸烟对肿瘤诊断时间的影响也是一种潜在解释。既往癫痫诊断相关的风险升高可能是一种监测假象，或者意味着癫痫和/或抗癫痫药物的使用易患听神经瘤。这些发现需要其他研究进行重复验证，并且需要阐明可能的机制。
