Vineis Paolo, Miligi Lucia, Costantini Adele Seniori
University of Turin, Turin, Italy.
Cancer Epidemiol Biomarkers Prev. 2007 Mar;16(3):381-4. doi: 10.1158/1055-9965.EPI-07-0124. Epub 2007 Mar 2.
Malignant lymphomas are a group of diseases of uncertain etiology. Both environmental factors and genetic susceptibility have been reported as risk factors. We have conducted a population-based case-control study in Italy: all newly diagnosed cases of malignant lymphoma, in males and females ages 20 to 74 years in the 1991 to 1993 period, were identified; the control group was comprised of a random sample of the general population resident in each of the areas under study, stratified by sex and 5-year age groups. Overall, 1,428 non-Hodgkin lymphoma (NHL) cases and 1,530 controls were interviewed. Experts from each geographic area examined questionnaire data and assigned a level of probability and intensity of exposure to a range of chemical groups and individual chemicals. For those in the medium/high level of exposure, there was an increased risk of NHL for exposure to benzene, xylene, and toluene. We have examined the hypothesis that the effect of solvents is related to their immunotoxicity by analyzing the interaction with a previous history of autoimmune disease. We have found an apparent, though not statistically significant, increased risk of NHL in those with both exposure to benzene and a history of autoimmune disease (odds ratio, 16.3; 95% confidence interval, 0.8-321). In addition, an odds ratio of 29.8 (95% confidence interval, 1.4-650.2, based on nine exposed cases) was associated with high-level exposure to benzene in those with a positive family history of malignant hematologic neoplasms. Both hypotheses (i.e., the interaction with autoimmune diseases and with familial predisposition) indirectly suggest that an immunologic mechanism could be involved in lymphomagenesis from solvents.
恶性淋巴瘤是一组病因不明的疾病。环境因素和遗传易感性均被报道为危险因素。我们在意大利开展了一项基于人群的病例对照研究：确定了1991年至1993年期间年龄在20至74岁的所有新诊断的男性和女性恶性淋巴瘤病例；对照组由每个研究区域常住的一般人群的随机样本组成，按性别和5岁年龄组分层。总体而言，对1428例非霍奇金淋巴瘤（NHL）病例和1530名对照进行了访谈。每个地理区域的专家检查了问卷数据，并确定了接触一系列化学类别和单个化学物质的可能性水平和接触强度。对于中/高接触水平的人群，接触苯、二甲苯和甲苯会增加患NHL的风险。我们通过分析与自身免疫性疾病既往史的相互作用，检验了溶剂的作用与其免疫毒性相关的假设。我们发现，同时接触苯和有自身免疫性疾病史的人群患NHL的风险有明显增加，尽管无统计学意义（优势比，16.3；95%置信区间，0.8 - 321）。此外，在有恶性血液肿瘤家族史阳性的人群中，高剂量接触苯与29.8的优势比（95%置信区间，1.4 - 650.2，基于9例接触病例）相关。这两个假设（即与自身免疫性疾病和家族易感性的相互作用）均间接表明免疫机制可能参与了溶剂诱导的淋巴瘤发生。
