Authors' Affiliations: The Brown School, Washington University in St. Louis; Department of Pediatrics, School of Medicine, Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri; Division of Epidemiology/Clinical Research, Department of Pediatrics and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota; University of Southern California, Los Angeles, California; University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Children's Hospital of Wisconsin, Milwaukee, Wisconsin; and Children's Hospital & Research Center of Oakland, Oakland, California.
Cancer Epidemiol Biomarkers Prev. 2013 Oct;22(10):1837-43. doi: 10.1158/1055-9965.EPI-13-0432. Epub 2013 Aug 15.
Hepatoblastoma is a rare pediatric liver tumor that has significantly increased in incidence over the last several decades. The International Agency for Research on Cancer (IARC) recently classified hepatoblastoma as a tobacco-related cancer. Parental alcohol use has shown no association. We examined associations between parental tobacco and alcohol use around the time of pregnancy and hepatoblastoma in a large case-control study.
Maternal interviews were completed for 383 cases diagnosed in the United States during 2000-2008. Controls (n = 387) were identified through U.S. birth registries and frequency-matched to cases on birth weight, birth year, and region of residence. We used unconditional logistic regression to calculate ORs and 95% confidence intervals (CI) for associations between parental smoking and maternal drinking and offspring hepatoblastoma.
We found no association between hepatoblastoma and maternal smoking at any time (OR, 1.0; 95% CI, 0.7-1.4), within the year before pregnancy (OR, 1.1; 95% CI, 0.8-1.6), early in pregnancy (OR, 1.0; 95% CI, 0.7-1.6), or throughout pregnancy (OR, 0.9; 95% CI, 0.5-1.6). We observed marginally positive associations between hepatoblastoma and paternal smoking in the year before pregnancy (OR, 1.4; 95% CI, 1.0-2.0) and during pregnancy (OR, 1.4; 95% CI, 0.9-2.0). Maternal alcohol use was not associated with hepatoblastoma.
Our results do not provide evidence for an etiologic relationship between maternal smoking or drinking and hepatoblastoma, and only weak evidence for an association for paternal smoking in the year before pregnancy.
Our study provides limited support for hepatoblastoma as a tobacco-related cancer; however, it remains wise to counsel prospective parents on the merits of smoking cessation.
肝癌是一种罕见的儿科肝脏肿瘤,在过去几十年中发病率显著增加。国际癌症研究机构(IARC)最近将肝癌归类为与烟草有关的癌症。父母饮酒与肝癌无关。我们在一项大型病例对照研究中检查了父母在怀孕前后吸烟和饮酒与肝癌之间的关系。
在美国,2000-2008 年间诊断出 383 例病例,对其母亲进行了访谈。对照组(n=387)通过美国出生登记处确定,并按出生体重、出生年份和居住地与病例进行频数匹配。我们使用无条件逻辑回归计算了父母吸烟和母亲饮酒与子女肝癌之间的关联的比值比(OR)和 95%置信区间(CI)。
我们没有发现肝癌与母亲任何时间的吸烟(OR,1.0;95%CI,0.7-1.4)、怀孕前一年(OR,1.1;95%CI,0.8-1.6)、怀孕早期(OR,1.0;95%CI,0.7-1.6)或整个孕期(OR,0.9;95%CI,0.5-1.6)之间存在关联。我们观察到肝癌与父亲在怀孕前一年(OR,1.4;95%CI,1.0-2.0)和怀孕期间(OR,1.4;95%CI,0.9-2.0)吸烟之间存在微弱的正相关。母亲饮酒与肝癌无关。
我们的结果没有提供母亲吸烟或饮酒与肝癌之间存在因果关系的证据,仅为父亲在怀孕前一年吸烟与肝癌之间存在关联提供了有限的证据。
我们的研究为肝癌作为一种与烟草有关的癌症提供了有限的支持;然而,建议准父母戒烟仍然是明智的。