Kanda Junya, Matsuo Keitaro, Kawase Takakazu, Suzuki Takeshi, Ichinohe Tatsuo, Seto Masao, Morishima Yasuo, Tajima Kazuo, Tanaka Hideo
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
Cancer Epidemiol Biomarkers Prev. 2009 Sep;18(9):2436-41. doi: 10.1158/1055-9965.EPI-09-0050. Epub 2009 Sep 1.
Given the lower incidence and differences in distribution of malignant lymphoma in Asian than western populations, the association of alcohol intake and smoking with malignant lymphoma risk in Asian populations merits investigation. Here, we conducted a sex- and age-matched case-control study of a Japanese population using two data sets, the first and second versions of the Hospital-based Epidemiological Research Program at Aichi Cancer Center Hospital (HERPACC-I and HERPACC-II, respectively), in 452 and 330 cases of histologically diagnosed malignant lymphoma and 2,260 and 1,650 noncancer controls, respectively. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using a conditional logistic regression model that incorporated smoking exposure and alcohol intake. Compared with nondrinking, consumption of >or=50 g/d by frequent drinkers was associated with significantly decreased risk in both data sets [OR (95% CI), 0.70 (0.53-0.93) for HERPACC-I and 0.40 (0.23-0.68) for HERPACC-II]. Given similar findings among groups, we used pooled data sets in subsequent analyses. For any alcohol intake versus nondrinking, point estimates of OR were less than unity for all four malignant lymphoma subtypes. In contrast, pack-years of smoking were associated with increased malignant lymphoma risk: relative to the reference (0-4 pack-years), OR (95% CI) were 1.32 (1.02-1.71), 1.39 (1.07-1.80), and 1.48 (1.12-1.95) for 5 to 19, 20 to 39, and >or=40 pack-years, respectively. This association with smoking was less apparent for all subtypes, except Hodgkin's lymphoma. In conclusion, we found that alcohol had an inverse association with malignant lymphoma risk across all malignant lymphoma subtypes in our Japanese subjects. Smoking appeared to be positively associated with malignant lymphoma risk, but this finding may vary by subtype.
鉴于亚洲人群中恶性淋巴瘤的发病率低于西方人群且分布存在差异，酒精摄入和吸烟与亚洲人群恶性淋巴瘤风险之间的关联值得研究。在此，我们利用两个数据集，对日本人群进行了一项性别和年龄匹配的病例对照研究，这两个数据集分别是爱知癌症中心医院基于医院的流行病学研究项目的第一版和第二版（分别为HERPACC - I和HERPACC - II），病例分别为452例和330例经组织学诊断的恶性淋巴瘤患者，非癌症对照分别为2260例和1650例。使用纳入吸烟暴露和酒精摄入情况的条件逻辑回归模型估计比值比（OR）和95%置信区间（95%CI）。与不饮酒者相比，在两个数据集中，经常饮酒者每日饮酒量≥50克均与风险显著降低相关[HERPACC - I的OR（95%CI）为0.70（0.53 - 0.93），HERPACC - II的OR（95%CI）为0.40（0.23 - 0.68）]。鉴于各亚组间有相似的发现，我们在后续分析中使用了合并数据集。对于任何饮酒情况与不饮酒相比，所有四种恶性淋巴瘤亚型的OR点估计值均小于1。相比之下，吸烟包年数与恶性淋巴瘤风险增加相关：相对于参考值（0 - 4包年），5至19包年、20至39包年以及≥40包年的OR（95%CI）分别为1.32（1.02 - 1.71）、1.39（1.07 - 1.80）和1.48（1.12 - 1.95）。除霍奇金淋巴瘤外，吸烟与所有亚型的这种关联不太明显。总之,我们发现酒精与我们日本研究对象中所有恶性淋巴瘤亚型的恶性淋巴瘤风险呈负相关。吸烟似乎与恶性淋巴瘤风险呈正相关，但这一发现可能因亚型而异。
