Rudant Jérémie, Menegaux Florence, Leverger Guy, Baruchel André, Nelken Brigitte, Bertrand Yves, Hartmann Olivier, Pacquement Hélène, Vérité Cécile, Robert Alain, Michel Gérard, Margueritte Geneviève, Gandemer Virginie, Hémon Denis, Clavel Jacqueline
INSERM, U754, Villejuif, France.
Int J Cancer. 2007 Jul 1;121(1):119-26. doi: 10.1002/ijc.22624.
The role of a family history of cancer in the etiology of childhood hematopoietic malignancies was investigated using the data from the ESCALE study. ESCALE, a population-based case-control study, was carried out in France over the period, 2003-2004. A total of 773 cases of acute leukemia (AL), 130 of Hodgkin's lymphoma (HL), 163 of non-Hodgkin's lymphoma (NHL) and 1,681 population-based controls were included. The controls were randomly selected from the French population and were frequency matched with the cases on age and gender. Cancer history in first- and second-degree relatives was reported by the mothers in a structured telephone questionnaire that was the same for the cases and controls. Odds ratios (ORs) were estimated using an unconditional regression model taking into account the stratification variables and potential confounders. A family history of cancer was associated with an increased risk of HL (OR = 1.5 [1.0-2.2]) and NHL (OR = 1.8 [1.3-2.5]), but not AL (OR = 1.0 [0.9-1.2]). The ORs were higher when at least 2 relatives had a history of cancer or when 1 case occurred before age 46 years. Only HL was significantly associated with a family history of hematopoietic malignancies (OR = 2.0 [1.0-3.8]), mainly because of a significant association with a history of HL (OR = 5.4 [1.3-22]). In conclusion, the study findings support the hypothesis of familial susceptibility to childhood lymphoma, but do not suggest familial susceptibility to childhood AL.
利用ESCALE研究的数据,对癌症家族史在儿童造血系统恶性肿瘤病因学中的作用进行了调查。ESCALE是一项基于人群的病例对照研究,于2003年至2004年期间在法国开展。共纳入了773例急性白血病(AL)、130例霍奇金淋巴瘤(HL)、163例非霍奇金淋巴瘤(NHL)以及1681名基于人群的对照。对照是从法国人群中随机选取的,并在年龄和性别上与病例进行频率匹配。母亲们通过一份结构化电话调查问卷报告一级和二级亲属的癌症病史,该问卷对病例和对照是相同的。使用无条件回归模型估计比值比(OR),同时考虑分层变量和潜在混杂因素。癌症家族史与HL(OR = 1.5 [1.0 - 2.2])和NHL(OR = 1.8 [1.3 - 2.5])风险增加相关,但与AL(OR = 1.0 [0.9 - 1.2])无关。当至少2名亲属有癌症病史或1例癌症发生在46岁之前时,OR更高。只有HL与造血系统恶性肿瘤家族史显著相关(OR = 2.0 [1.0 - 3.8]),主要是因为与HL病史显著相关(OR = 5.4 [1.3 - 22])。总之,研究结果支持儿童淋巴瘤存在家族易感性的假设,但不提示儿童AL存在家族易感性。