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儿童生命第一年的感染暴露与中枢神经系统肿瘤风险:日托、社交接触和过度拥挤情况分析

Infectious exposure in the first year of life and risk of central nervous system tumors in children: analysis of day care, social contact, and overcrowding.

作者信息

Harding N J, Birch J M, Hepworth S J, McKinney P A

机构信息

Paediatric Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Worsley Building, LS2 9JT, Leeds, UK.

出版信息

Cancer Causes Control. 2009 Mar;20(2):129-36. doi: 10.1007/s10552-008-9224-8. Epub 2008 Sep 3.

Abstract

Little is known regarding the aetiology of central nervous system tumors in children. Recent studies have speculated on a potential infectious aetiology, but no clear associations have been found. This article uses parent reported questionnaire data from the UK Childhood Cancer Study (UKCCS), a population-based case-control study, to examine the relationship between the infectious exposure in the first year of life and the likelihood of developing a CNS tumor. The variables representing infectious exposure were social contact (including social contact with other infants and attendance at informal and formal day care), sharing a bedroom with another child, birth order, and exposure to a school-age child within the home. Children reported to have had no social contact with other infants in the first year of life displayed an increased risk of developing a CNS tumor when compared to those who had (OR 1.37, 95% CI 1.08-1.75). This effect was most prominent in the primitive neuroectodermal tumor/medulloblastoma subgroup (OR 1.78, 95% CI 1.12-2.83). Those who had attended informal (OR 0.86, 95% CI 0.68-1.09) or formal day care (OR 0.93, 95% CI 0.68-1.26) showed slightly non-statistically significant reduced risks when compared to those reporting social contact only. No association with any of the other variables was observed. Overall, the inconsistent findings by variable and tumor subtype suggest that an early exposure to infections is not strongly implicated in the aetiology of CNS tumors. However, the effect for social contact outside the home, particularly for PNET/medulloblastomas warrants further investigation.

摘要

关于儿童中枢神经系统肿瘤的病因,人们知之甚少。最近的研究推测了潜在的感染性病因,但尚未发现明确的关联。本文使用来自英国儿童癌症研究(UKCCS)的家长报告问卷数据,这是一项基于人群的病例对照研究,以检验生命第一年的感染暴露与患中枢神经系统肿瘤可能性之间的关系。代表感染暴露的变量包括社交接触(包括与其他婴儿的社交接触以及参加非正式和正式日托)、与另一个孩子共用卧室、出生顺序以及在家中接触学龄儿童。与有社交接触的儿童相比,报告在生命第一年没有与其他婴儿进行社交接触的儿童患中枢神经系统肿瘤的风险增加(比值比1.37,95%置信区间1.08 - 1.75)。这种效应在原始神经外胚层肿瘤/髓母细胞瘤亚组中最为显著(比值比1.78,95%置信区间1.12 - 2.83)。与仅报告有社交接触的儿童相比,参加非正式日托(比值比0.86,95%置信区间0.68 - 1.09)或正式日托(比值比0.93,95%置信区间0.68 - 1.26)的儿童显示出略有降低的风险,但无统计学意义。未观察到与任何其他变量的关联。总体而言,变量和肿瘤亚型的结果不一致表明,早期接触感染与中枢神经系统肿瘤的病因没有强烈关联。然而,家庭外社交接触的影响,特别是对原始神经外胚层肿瘤/髓母细胞瘤的影响值得进一步研究。

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