Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
BMC Cancer. 2012 Jan 13;12:13. doi: 10.1186/1471-2407-12-13.
We specifically tested the aetiological hypothesis that a factor influencing geographical or temporal heterogeneity of childhood central nervous system (CNS) tumour incidence was related to exposure to a transient environmental agent.
Information was extracted on individuals aged 0-14 years, diagnosed with a CNS tumour between the 1st January 1974 and 31st December 2006 from the Yorkshire Specialist Register of Cancer in Children and Young People. Ordnance Survey eight-digit grid references were allocated to each case with respect to addresses at the time of birth and the time of diagnosis, locating each address to within 0.1 km. The following diagnostic groups were specified a priori for analysis: ependymoma; astrocytoma; primitive neuroectodermal tumours (PNETs); other gliomas; total CNS tumours. We applied the K-function method for testing global space-time clustering using fixed geographical distance thresholds. Tests were repeated using variable nearest neighbour (NN) thresholds.
There was statistically significant global space-time clustering for PNETs only, based on time and place of diagnosis (P = 0.03 and 0.01 using the fixed geographical distance and the variable NN threshold versions of the K-function method respectively).
There was some evidence for a transient environmental component to the aetiology of PNETs. However, a possible role for chance cannot be excluded.
我们专门测试了一个病因假设,即影响儿童中枢神经系统(CNS)肿瘤发病率的地理或时间异质性的因素与暴露于短暂的环境因素有关。
从 1974 年 1 月 1 日至 2006 年 12 月 31 日期间,从约克郡儿童和青少年癌症专科登记册中提取了年龄在 0-14 岁之间、被诊断为 CNS 肿瘤的个体的信息。根据出生时和诊断时的地址,为每个病例分配了 Ordnance Survey 八位数字网格参考,将每个地址定位在 0.1 公里内。为分析指定了以下预先确定的诊断组:室管膜瘤;星形细胞瘤;原始神经外胚层肿瘤(PNETs);其他神经胶质瘤;总 CNS 肿瘤。我们应用 K 函数方法,使用固定的地理距离阈值测试全球时空聚类。使用可变最近邻(NN)阈值重复了测试。
仅基于诊断时的时间和地点,PNETs 存在统计学上显著的全球时空聚类(使用固定地理距离和可变 NN 阈值版本的 K 函数方法,P 值分别为 0.03 和 0.01)。
有证据表明 PNETs 的病因中存在短暂的环境因素。然而,不能排除偶然性的可能作用。