Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA.
J Neurosurg. 2011 Dec;115(6):1072-7. doi: 10.3171/2011.6.JNS11129. Epub 2011 Jul 22.
Little is known about the epidemiology of meningioma, the most frequently reported primary brain tumor in the US. The authors undertook a case-control study to examine the relationship between family and personal medical history and meningioma risk.
The authors compared the personal and first-degree family histories of 1124 patients with meningioma (age range 20-79 years) in Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 Houston counties between May 1, 2006, and February 26, 2010, and the histories of 1000 control individuals who were frequency-matched for age, sex, and geography.
The patients were more likely than the controls to report a first-degree family history of meningioma (OR 4.4, 95% CI 1.6-11.5), and there was an even stronger association in younger cases. The patients were less likely than controls to report immune conditions including allergy (OR 0.6, 95% CI 0.5-0.7) but were more likely to report a history of thyroid cancer (OR 4.7, 95% CI 1.02-21.5) or leukemia (OR 5.4, 95% CI 1.2-24.1) (most after radiotherapy). Among women, patients were more likely than controls to report hormonally related conditions--uterine fibroid tumors (OR 1.2, 95% CI 1.0-1.5), endometriosis (OR 1.5, 95% CI 1.5-2.1), and breast cancer (OR 1.4, 95% CI 0.8-2.3).
The influence of genetics, the immune system, and radiation near the head on meningioma risk is suggested in the authors' findings; the role of hormones is intriguing but requires further study.
脑膜瘤是美国最常见的原发性脑肿瘤,但其流行病学情况知之甚少。作者开展了一项病例对照研究,旨在探讨家族和个人病史与脑膜瘤风险之间的关系。
作者比较了 2006 年 5 月 1 日至 2010 年 2 月 26 日期间在康涅狄格州、马萨诸塞州、北卡罗来纳州、旧金山湾区和休斯顿的 8 个县确诊的 1124 例脑膜瘤患者(年龄 20-79 岁)和 1000 例年龄、性别和地理位置相匹配的对照者的个人一级亲属病史。
脑膜瘤患者一级亲属中有脑膜瘤病史的比例高于对照组(比值比 4.4,95%置信区间 1.6-11.5),且在较年轻的病例中相关性更强。与对照组相比,脑膜瘤患者报告自身有免疫性疾病(比值比 0.6,95%置信区间 0.5-0.7)的比例较低,但报告有甲状腺癌(比值比 4.7,95%置信区间 1.02-21.5)或白血病(比值比 5.4,95%置信区间 1.2-24.1)病史的比例较高(多数有放疗史)。在女性中,与对照组相比,脑膜瘤患者报告有与激素相关的疾病——子宫肌瘤(比值比 1.2,95%置信区间 1.0-1.5)、子宫内膜异位症(比值比 1.5,95%置信区间 1.5-2.1)和乳腺癌(比值比 1.4,95%置信区间 0.8-2.3)的比例较高。
作者的研究结果提示遗传因素、免疫系统和头部附近的辐射对脑膜瘤风险有影响;激素的作用引人关注,但需要进一步研究。