Rollison Dana E, Helzlsouer Kathy J, Lee Ji-Hyun, Fulp William, Clipp Sandra, Hoffman-Bolton Judy A, Giuliano Anna R, Platz Elizabeth A, Viscidi Raphael P
H.Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Cancer Epidemiol Biomarkers Prev. 2009 May;18(5):1515-23. doi: 10.1158/1055-9965.EPI-08-1119. Epub 2009 Apr 21.
Infection with JC virus has been proposed as a risk factor for colorectal cancer. A nested case-control study was conducted to evaluate the association between prediagnostic JC virus antibodies and the risk of incident colorectal cancer and adenomas.
Two research serum banks were established in Washington County, MD in 1974 and 1989, with the collection of blood samples from >45,000 volunteers. Incident colorectal cancer cases diagnosed through 2006 (n = 611) were identified among participants by linkage to population-based cancer registries, contributing 729 pairs of observations. Cases of adenomatous polyps (n = 123) were identified from participants of the 1989 cohort who reported having a colonoscopy-detected adenoma at follow-up through 2000 with histology confirmed through medical record review. One control was matched to each case on age, sex, race, and date of blood draw, and, for adenoma controls, date of endoscopy. IgG antibodies to JC virus were measured using virus-like particle ELISA. Associations between JC virus seropositivity and colorectal cancer and adenomas were estimated using conditional logistic regression.
Overall, there was no association between antibodies to JC virus and colorectal cancer [odds ratio (OR), 0.91; 95% confidence interval (95% CI), 0.71-1.17]. However, a statistically significant positive association between JC virus seropositivity and subsequent adenoma diagnosis was observed among males (OR, 2.31; 95% CI, 1.20-4.46), whereas a statistically significant inverse association was observed among females (OR, 0.31; 95% CI, 0.14-0.67; P for interaction = 0.01), after adjustment for baseline smoking and body mass index.
Overall, JC virus seropositivity was not associated with colorectal cancer development up to 31 years later. Future studies are needed to confirm the adenoma findings.
有人提出,感染JC病毒是结直肠癌的一个风险因素。开展了一项巢式病例对照研究,以评估诊断前JC病毒抗体与结直肠癌及腺瘤发病风险之间的关联。
1974年和1989年在马里兰州华盛顿县建立了两个研究血清库,收集了超过45000名志愿者的血样。通过与基于人群的癌症登记处建立联系,在参与者中确定了截至2006年诊断出的结直肠癌病例(n = 611),提供了729对观察数据。腺瘤性息肉病例(n = 123)是从1989年队列的参与者中确定的,这些参与者报告在2000年随访时通过结肠镜检查发现腺瘤,并通过病历审查确认了组织学结果。为每个病例匹配一名年龄、性别、种族和采血日期相同的对照,对于腺瘤对照,匹配内镜检查日期。使用病毒样颗粒酶联免疫吸附测定法检测针对JC病毒的IgG抗体。使用条件逻辑回归估计JC病毒血清阳性与结直肠癌及腺瘤之间的数据关联。
总体而言,JC病毒抗体与结直肠癌之间无关联[比值比(OR),0.91;95%置信区间(95%CI),0.71 - 1.17]。然而,在调整基线吸烟和体重指数后,在男性中观察到JC病毒血清阳性与随后的腺瘤诊断之间存在统计学显著的正相关(OR,2.31;95%CI,1.20 - 4.46),而在女性中观察到统计学显著的负相关(OR,0.31;95%CI,0.14 - 0.67;交互作用P值 = 0.01)。
总体而言,JC病毒血清阳性在31年后与结直肠癌发生无关。需要进一步的研究来证实腺瘤的研究结果。