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围生期风险因素与儿童睾丸生殖细胞肿瘤:一项基于北欧人群的研究。

Perinatal risk factors for childhood testicular germ-cell cancer: a Nordic population-based study.

机构信息

Clinical Epidemiology Unit and Centre for Pharmacoepidemiology, Department of Medicine, Karolinska University Hospital and Institute, Stockholm, Sweden.

出版信息

Cancer Epidemiol. 2011 Dec;35(6):e100-4. doi: 10.1016/j.canep.2011.07.003. Epub 2011 Aug 16.

Abstract

INTRODUCTION

In contrast to research in adults, there have been limited studies on testicular germ-cell cancer among boys aged <15 years. The aim of the study was to investigate the association between perinatal characteristics and childhood testicular germ-cell cancer.

METHODS

We identified 152 patients with childhood germ-cell cancer among boys (<15 years) born in Norway, Sweden, Finland and Denmark between 1967 and 2006 using the cancer and medical birth registries. For each case we sampled 10 population controls matched on year and country of birth. We used conditional logistic regression analysis to estimate odds ratios for cancer risk.

RESULTS

There was a weak, positive association between high (≥4000 g) birth weight and childhood testicular germ-cell cancer (adjusted OR=1.25; 95% CI: 0.83-1.90) compared with normal birth weight, and a correspondingly elevated risk for low birth weight (adjusted OR=1.41; 95% CI: 0.43-4.56). For Ponderal Index (PI) there was an increased risk for low and high values compared to those in the middle category (adjusted OR=1.64; 95% CI: 1.03-2.62 and 1.67; 95% CI: 0.93-2.99), respectively. There was no association between birth length and childhood testicular germ-cell cancer. The adjusted OR for testicular cancer among first born was 1.40; 95% CI: 0.96-2.05. Greater maternal age and less maternal education appeared to increase the risk, but the estimates were not statistically significant.

CONCLUSION

We found a U-shaped association between fetal growth, measured as the PI, and childhood testicular germ-cell cancer. Our findings support the notion that abnormal fetal growth rate confers a risk in pediatric testicular cancer [corrected].

摘要

引言

与成人研究相比,针对<15 岁男孩的睾丸生殖细胞癌的研究有限。本研究旨在探讨围产期特征与儿童睾丸生殖细胞癌之间的关系。

方法

我们使用癌症和医疗出生登记处,确定了 1967 年至 2006 年期间在挪威、瑞典、芬兰和丹麦出生的<15 岁男孩中患有儿童生殖细胞癌的 152 名患者。对于每个病例,我们按出生年份和国家匹配了 10 名人群对照。我们使用条件逻辑回归分析来估计癌症风险的优势比。

结果

与正常出生体重相比,高(≥4000 克)出生体重与儿童睾丸生殖细胞癌呈弱正相关(调整后的优势比=1.25;95%置信区间:0.83-1.90),而低出生体重的风险相应升高(调整后的优势比=1.41;95%置信区间:0.43-4.56)。对于 ponderal index(PI),与中间类别相比,低值和高值的风险增加(调整后的优势比分别为 1.64;95%置信区间:1.03-2.62 和 1.67;95%置信区间:0.93-2.99)。出生长度与儿童睾丸生殖细胞癌无关。头胎的调整后的优势比为 1.40;95%置信区间:0.96-2.05。母亲年龄较大和受教育程度较低似乎增加了风险,但估计没有统计学意义。

结论

我们发现胎儿生长(以 ponderal index 衡量)与儿童睾丸生殖细胞癌之间呈 U 形关联。我们的研究结果支持这样一种观点,即异常的胎儿生长速度会增加儿科睾丸癌的风险。

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