Inserm UMRS1018, CESP, Université Paris Sud, Villejuif, France.
Int J Cancer. 2011 Nov 1;129(9):2236-47. doi: 10.1002/ijc.25862. Epub 2011 Apr 1.
The study investigated the role of factors considered related to the early stimulation of the immune system in the aetiology of childhood lymphoma. The national registry-based case-control study, Escale, was carried out in France over the period 2003-2004. Population controls were frequency matched with the cases on age and gender. Data were obtained from structured telephone questionnaires administered to mothers. Odds ratios (ORs) were estimated using unconditional regression models adjusted for potential confounders. Data from 128 cases of Hodgkin's lymphoma (HL) aged 5-14 years, 164 cases of non-Hodgkin's lymphoma (NHL) aged 2-14 years and 1,312 controls were analyzed. Negative associations were observed between HL and day care attendance [OR = 0.5 (0.2-1.2)] and between HL and repeated early common infections among non-breastfed children [OR = 0.3 (.2-0.7), p = 0.003] [OR for breastfed children: 1.0 (.5-2.1)], but not for the other factors investigated. Negative associations were observed between NHL and birth order 3 or more [OR = 0.7 (0.4-1.1)], prolonged breastfeeding [OR = 0.5 (0.3-1.0)], regular contact with farm animals [OR = 0.5 (0.3-1.0)], frequent farm visits in early life [OR = 0.6 (0.4-1.1)] and history of asthma [OR = 0.6 (0.3-1.1)]. In conclusion, the results partly support the hypothesis that an abnormal maturation of the immune system may play a role in childhood HL or NHL, and call for further investigations.
该研究调查了被认为与儿童淋巴瘤发病机制早期免疫系统刺激相关的因素的作用。这项基于全国登记的病例对照研究 Escale 于 2003-2004 年在法国进行。人口对照与病例按年龄和性别进行频数匹配。数据来自于对母亲进行的结构化电话问卷调查。使用调整潜在混杂因素的非条件回归模型估计比值比(OR)。共分析了 128 例年龄 5-14 岁的霍奇金淋巴瘤(HL)病例、164 例年龄 2-14 岁的非霍奇金淋巴瘤(NHL)病例和 1312 例对照的资料。HL 与日托出勤率低[OR=0.5(0.2-1.2)]和非母乳喂养儿童反复早期常见感染之间呈负相关[OR=0.3(0.2-0.7),p=0.003][母乳喂养儿童的 OR:1.0(0.5-2.1)],但与其他研究因素无关。NHL 与排行第三或更高[OR=0.7(0.4-1.1)]、母乳喂养时间长[OR=0.5(0.3-1.0)]、经常接触农场动物[OR=0.5(0.3-1.0)]、早期生活中经常去农场[OR=0.6(0.4-1.1)]和哮喘史[OR=0.6(0.3-1.1)]之间呈负相关。总之,研究结果部分支持了免疫系统异常成熟可能在儿童 HL 或 NHL 中起作用的假说,并呼吁进一步研究。