Baldi I, Huchet A, Bauchet L, Loiseau H
Laboratoire santé travail et environnement, hôpital Pellegrin, université de Bordeaux, 2, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
Neurochirurgie. 2010 Dec;56(6):433-40. doi: 10.1016/j.neuchi.2010.07.011. Epub 2010 Sep 24.
An increasing incidence of glioblastoma has been observed over the last 30 years. Improvements in diagnostic tools such as CT scans and MRI, changes observed in histological classifications, and adjustments in neurosurgical practices have contributed substantially to this increase. Moreover, the aging of the population and the increasing occurrence of glioblastoma beyond 60 years of age are additional explanations. In Gironde (France), where a specialized registry has been established, the annual incidence of glioblastoma is 4.96/100,000. Wide geographic variations are observed, possibly linked to ethnicity. However, the role of intrinsic and/or extrinsic factors cannot be ruled out. Comparing data between registries is difficult and requires taking into account periods of recruitment and diagnostic tools. Ethnicity, age, sex, hereditary syndromes, some constitutive polymorphisms, and brain irradiation are the established risk factors Allergies or asthma, certain viral infections, autoimmune diseases, nonsteroidal anti-inflammatory drug intake, substitutive hormonal therapy, and dietary antioxidant intake are the established protective factors. Many studies on electromagnetic fields - in particular cellular phones - pesticides, solvents, and other factors have been published. Until now, the results are discordant or are not confirmed because of methodological limitations. Future studies combining constitutive polymorphisms and exposure assessment are likely to provide consistent and important data that will improve our knowledge in the epidemiology of glioblastoma.
在过去30年中,已观察到胶质母细胞瘤的发病率不断上升。CT扫描和MRI等诊断工具的改进、组织学分类中观察到的变化以及神经外科手术操作的调整,在很大程度上促成了这一增长。此外,人口老龄化以及60岁以上人群中胶质母细胞瘤发病率的增加也是其他原因。在已建立专门登记处的法国吉伦特省,胶质母细胞瘤的年发病率为4.96/10万。观察到存在广泛的地理差异,这可能与种族有关。然而,内在和/或外在因素的作用也不能排除。比较不同登记处的数据很困难,需要考虑招募时间和诊断工具。种族、年龄、性别、遗传综合征、一些组成型多态性和脑部放疗是已确定的危险因素。过敏或哮喘、某些病毒感染、自身免疫性疾病、非甾体抗炎药的摄入、替代激素疗法以及饮食中抗氧化剂的摄入是已确定的保护因素。关于电磁场——尤其是手机、农药、溶剂和其他因素的许多研究已经发表。到目前为止,由于方法学上的局限性,结果不一致或未得到证实。未来结合组成型多态性和暴露评估的研究可能会提供一致且重要的数据,从而增进我们对胶质母细胞瘤流行病学的了解。