Department of Radiation Oncology, Mount Sinai School of Medicine, Box 1236, NY 10029, USA.
Med Hypotheses. 2012 May;78(5):657-8. doi: 10.1016/j.mehy.2012.02.003. Epub 2012 Mar 3.
Glioblastoma multiforme is the most common and most aggressive type of primary brain tumor, accounting for 52% of all primary brain tumor cases and 20% of all intracranial tumors. Recently, evidence for a viral cause has been postulated, possibly cytomegalovirus (CMV). In one report, 80% of patients with newly diagnosed glioblastoma multiforme had detectable cytomegalovirus DNA in their peripheral blood, while sero-positive normal donors and other surgical patients did not exhibit detectable virus. However, another study reported that five glioblastoma patients showed no circulating CMV detected either with RT-PCR or blood culture. But CMV could still be a factor in the genesis of glioblastoma multiforme, if age at infection is taken into account, since the incidence of both glioblastoma multiforme and CMV infection are inversely related to socioeconomic status. CMV infection in early childhood, more common in lower socioeconomic groups, may be protective against glioblastoma multiforme, whereas CMV infection in later childhood or adulthood may be a risk factor for glioblastoma. If so, glioblastoma multiforme occurrence would resemble paralytic polio, where low socioeconomic status, poor hygiene and early infection are protective.
多形性胶质母细胞瘤是最常见和最具侵袭性的原发性脑肿瘤,占所有原发性脑肿瘤病例的 52%,占所有颅内肿瘤的 20%。最近,有人提出病毒可能是病因,可能是巨细胞病毒(CMV)。在一份报告中,80%新诊断为多形性胶质母细胞瘤的患者在外周血中可检测到巨细胞病毒 DNA,而血清阳性的正常供体和其他手术患者则未检测到可检测到的病毒。然而,另一项研究报告称,五名胶质母细胞瘤患者既未通过 RT-PCR 也未通过血液培养检测到循环 CMV。但是,如果考虑到感染时的年龄,CMV 仍可能是多形性胶质母细胞瘤发生的一个因素,因为多形性胶质母细胞瘤和 CMV 感染的发病率与社会经济地位呈反比。在儿童早期感染 CMV 更为常见于社会经济地位较低的人群,可能对多形性胶质母细胞瘤有保护作用,而在儿童后期或成年期感染 CMV 则可能是多形性胶质母细胞瘤的危险因素。如果是这样,多形性胶质母细胞瘤的发生就类似于麻痹性脊髓灰质炎,社会经济地位较低、卫生条件差和早期感染对其有保护作用。