Rosenblatt K A, Koepsell T D, Daling J R, Lyon J L, Swanson G M, Greenberg R S, Weiss N S
Department of Epidemiology, University of Washington, Seattle 98195.
Am J Epidemiol. 1991 Jul 1;134(1):22-8. doi: 10.1093/oxfordjournals.aje.a115989.
Data from a population-based case-control study of chronic lymphocytic leukemia were analyzed to assess the possible etiologic role of chronic antigenic stimulation. The study, conducted in four geographic areas of the United States (the metropolitan areas surrounding Seattle, Washington, Salt Lake City, Utah, Detroit, Michigan, and Atlanta, Georgia) sought to identify all incident cases (n = 430) among residents diagnosed between July 1, 1977 and December 31, 1981. The responses of these cases to questions about possible sources of antigenic stimulation were compared with the responses of controls selected from the populations of these areas. Little difference between cases and controls was present for a history of most forms of viral and bacterial infection and for a history of allergies or allergy treatment. However, a relation was observed with antecedent syphilis infection (odds ratio (OR) = 5.0, 95% confidence interval (Cl) 2.0-12.9). Associations of smaller magnitude were observed with a history of tuberculosis (OR = 1.9, 95% Cl 1.0-3.7) and of urinary tract infection (OR = 1.4, 95% Cl 1.1-1.9). Overall, however, the authors found little evidence of a relation between chronic antigenic stimulation and the occurrence of chronic lymphocytic leukemia. Nonetheless, because the measure of prior antigenic stimulation was restricted to that obtained through interviews and undoubtedly was an insensitive one, these negative results should not be interpreted as ruling out antigenic stimulation as a possible cause of some cases of chronic lymphocytic leukemia.
对一项基于人群的慢性淋巴细胞白血病病例对照研究的数据进行了分析，以评估慢性抗原刺激可能的病因学作用。该研究在美国四个地理区域（华盛顿州西雅图、犹他州盐湖城、密歇根州底特律和佐治亚州亚特兰大周边的大都市区）开展，旨在识别1977年7月1日至1981年12月31日期间被诊断出的所有居民中的新发病例（n = 430）。将这些病例对有关抗原刺激可能来源问题的回答与从这些地区人群中选取的对照的回答进行了比较。在大多数病毒和细菌感染史以及过敏或过敏治疗史方面，病例与对照之间差异不大。然而，观察到与既往梅毒感染存在关联（比值比（OR）= 5.0，95%置信区间（Cl）2.0 - 12.9）。还观察到与结核病史（OR = 1.9，95% Cl 1.0 - 3.7）和尿路感染史（OR = 1.4，95% Cl 1.1 - 1.9）存在较小程度的关联。然而，总体而言，作者发现几乎没有证据表明慢性抗原刺激与慢性淋巴细胞白血病的发生之间存在关联。尽管如此，由于先前抗原刺激的测量仅限于通过访谈获得的信息，而且无疑是不敏感的，这些阴性结果不应被解释为排除抗原刺激作为某些慢性淋巴细胞白血病病例可能病因的可能性。
