癌症和非恶性疾病家族史与儿童急性淋巴细胞白血病风险：儿童肿瘤协作组研究。
Family history of cancer and non-malignant diseases and risk of childhood acute lymphoblastic leukemia: a Children's Oncology Group Study.
机构信息
University of Minnesota-Twin Cities, MMC 715 420 Delaware Street, SE, Minneapolis, MN 55455, USA.
出版信息
Cancer Epidemiol. 2012 Feb;36(1):45-51. doi: 10.1016/j.canep.2011.06.004. Epub 2011 Oct 21.
BACKGROUND
Studies of family history of cancer and non-malignant diseases in childhood acute lymphoblastic leukemia (ALL) show inconsistent findings. Most studies show no increased risk with family history of cancer. Non-malignant diseases such as allergic diseases, autoimmune diseases, birth defects and thyroid diseases have been reported to be associated with ALL.
METHODS
We conducted a case-control study of family history of cancer and selected non-malignant conditions (allergic diseases, autoimmune diseases, birth defects, and thyroid diseases). ALL cases were obtained from Children's Cancer Group institutions from January 1989 to June 1993. Controls were recruited via random digit dialing. Family history for first degree relatives and grandparents of ALL cases and controls was collected by structured telephone questionnaires. Conditional logistical regression was used to calculate odds ratios adjusting for potential confounders.
RESULTS
We found a borderline association of ALL and having a family member with a history of cancer in cases (n=1842) compared to controls (n=1986) (OR=0.98, 95%CI=0.93, 1.00) and an inverse association for esophageal cancer based on small numbers. Family history of food and drug allergies demonstrated a modestly reduced risk (OR=0.83, 95%CI=0.73, 0.95) as did family history of rheumatoid arthritis (OR=0.79, 95%CI=0.65, 0.96). There were no associations with family history of any autoimmune diseases, immunodeficiencies, birth defects, thyroid diseases and risk of childhood ALL.
CONCLUSIONS
These results show no association of overall family history of cancer with childhood ALL, while providing additional evidence for an inverse association with family history of allergic disease. Two potentially new associations of ALL with family history of esophageal cancer and rheumatoid arthritis require confirmation in other studies and validation with medical records.
背景
癌症和非恶性疾病家族史的研究在儿童急性淋巴细胞白血病（ALL）中得出的结果并不一致。多数研究表明，癌症家族史并不会增加 ALL 的发病风险。过敏症、自身免疫性疾病、先天缺陷和甲状腺疾病等非恶性疾病与 ALL 相关。
方法
我们进行了一项关于癌症和选定非恶性疾病（过敏症、自身免疫性疾病、先天缺陷和甲状腺疾病）家族史的病例对照研究。ALL 病例来源于儿童癌症组机构，研究时间为 1989 年 1 月至 1993 年 6 月。对照组通过随机数字拨号招募。通过结构电话问卷收集 ALL 病例和对照组一级亲属和祖父母的家族史。采用条件逻辑回归调整潜在混杂因素后计算比值比。
结果
我们发现 ALL 病例（n=1842）一级亲属和祖父母有癌症病史的比例（n=1986）与对照组（OR=0.98，95%CI=0.93，1.00）相比有边界关联，且基于数量较少的食管癌病例显示出反比关联。食物和药物过敏史显示出适度降低的风险（OR=0.83，95%CI=0.73，0.95），类风湿关节炎家族史（OR=0.79，95%CI=0.65，0.96）也如此。但家族史中任何自身免疫性疾病、免疫缺陷、先天缺陷、甲状腺疾病与儿童 ALL 风险均无关联。
结论
这些结果表明，总体癌症家族史与儿童 ALL 无关，同时提供了过敏症家族史与 ALL 呈反比关联的更多证据。ALL 与食管癌和类风湿关节炎家族史之间的两个潜在新关联需要在其他研究中进行确认，并通过病历进行验证。
Zotero 插件