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儿童白血病、非霍奇金淋巴瘤和肾母细胞瘤:出生体重的作用。

Leukemia, non-Hodgkin's lymphoma, and Wilms tumor in childhood: the role of birth weight.

机构信息

Division of Nephrology, School of Medicine, Federal University of São Paulo, Rua Botucatu, 740, 04023-900, São Paulo, SP, Brazil.

出版信息

Eur J Pediatr. 2010 Jul;169(7):875-81. doi: 10.1007/s00431-010-1139-1. Epub 2010 Jan 26.

DOI:10.1007/s00431-010-1139-1
PMID:20101509
Abstract

There is emerging evidence that higher birth weight is associated with increased risk of cancer, in particular childhood leukemia. The purpose of this paper is to study whether this correlation is also significant with other childhood cancer. For this, we conducted a case-control study including 410 childhood cancer patients and 1,575 matched controls to investigate birth weight as a risk factor for leukemia, Wilms tumor, and non-Hodgkin's lymphoma. The estimated risk for all cancers has been found to be statistically and significantly higher in birth weight of more than 4,000 g (odds ratio, 2.50 and 95% confidence intervals (CI), 1.72-3.63). For leukemia, the estimated risk was 1.86 (95% CI, 1.04-3.30), for non-Hodgkin lymphoma, 1.99 (95% CI, 1.08-3.69), and being more remarkable for Wilms tumor, 4.76 (95% CI, 2.73-8.28). Moreover, moderate increased risk of both leukemia and non-Hodgkin lymphoma was also associated with birth weight between 3,000 and 3,999 g. High birth weight was associated with all cancers also when adjusted by gestational age, length at birth, and gender (odds ratio, 6.10 and 95% CI, 1.15-32.57). No associations were found for maternal alcohol consumption during pregnancy, maternal smoking, or smoking by other people at home or presence of obstetric variables (e.g., gestational diabetes, preeclampsia, and abruptio placentae). The present study supports the hypothesis that high birth weight is an independent risk factor for childhood Wilms tumor, leukemia, and non-Hodgkin lymphoma. Further studies should explore biological reasons to explain this relationship and, ultimately, to expand our knowledge about prenatal influences on the occurrence of this disease.

摘要

越来越多的证据表明,较高的出生体重与癌症风险增加有关,特别是儿童白血病。本文旨在研究这种相关性是否也与其他儿童癌症有关。为此,我们进行了一项病例对照研究,纳入了 410 名儿童癌症患者和 1575 名匹配对照,以调查出生体重是否为白血病、肾母细胞瘤和非霍奇金淋巴瘤的危险因素。研究发现,出生体重超过 4000 克的儿童患所有癌症的风险显著增加(比值比,2.50;95%置信区间[CI],1.72-3.63)。对于白血病,估计风险为 1.86(95%CI,1.04-3.30),对于非霍奇金淋巴瘤,为 1.99(95%CI,1.08-3.69),对于肾母细胞瘤,更为显著,为 4.76(95%CI,2.73-8.28)。此外,出生体重在 3000 至 3999 克之间与白血病和非霍奇金淋巴瘤的中度风险增加也有关。即使在校正胎龄、出生时的身长和性别后,高出生体重与所有癌症之间也存在关联(比值比,6.10;95%CI,1.15-32.57)。在怀孕期间母亲饮酒、母亲吸烟或家中其他人吸烟以及存在产科变量(如妊娠期糖尿病、先兆子痫和胎盘早剥)与儿童癌症之间没有关联。本研究支持高出生体重是儿童肾母细胞瘤、白血病和非霍奇金淋巴瘤的独立危险因素的假说。进一步的研究应该探讨生物学原因来解释这种关系,并最终扩大我们对产前因素对这种疾病发生的影响的认识。

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