Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Box 951772, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, MC 9175, Los Angeles, CA 90089-9175, USA.
Cancer Epidemiol. 2014 Feb;38(1):48-55. doi: 10.1016/j.canep.2013.11.005. Epub 2013 Dec 15.
Lymphoma is the third most common childhood malignancy and comprises two types, Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). The etiology of pediatric lymphomas is largely unknown, but has been suggested to have prenatal origins.
In this population-based study, California birth certificates were identified for 478 lymphoma cases diagnosed in children 0-5 years of age between 1988 and 2007; 208,015 controls frequency-matched by birth year were randomly selected from California birth records.
Compared to non-Hispanic whites, Hispanic children had an increased risk of HL (odds ratio (OR) and 95% confidence interval (CI) 2.43 [1.14, 5.17]), and in particular, were diagnosed more often with the mixed cellularity subtype. For all types of lymphoma, we observed an about twofold risk increase with indicators for high risk pregnancies including tocolysis, fetopelvic disproportion and previous preterm birth. NHL risk doubled with the complication premature rupture of membranes (OR and 95% CI 2.18 [1.12, 4.25]) and HL with meconium staining of amniotic fluids (OR and 95% CI 2.55 [1.01, 6.43]).
These data support previously reported associations between Hispanic ethnicity and HL and suggest that pregnancy related factors, such as intra-uterine infections and factors associated with preterm labor, may be involved in lymphoma pathogenesis.
淋巴瘤是儿童期第三大常见恶性肿瘤，包括霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）两种类型。儿童淋巴瘤的病因在很大程度上尚不清楚，但有研究提示其发病与产前因素有关。
本研究为基于人群的病例对照研究，选择 1988 年至 2007 年间加利福尼亚州诊断为 0-5 岁儿童淋巴瘤的 478 例病例，以及 208,015 名按出生年份与病例相匹配的对照。通过加利福尼亚州出生记录，识别病例和对照的出生证明。
与非西班牙裔白人相比，西班牙裔儿童患 HL 的风险增加（比值比（OR）和 95%置信区间（CI）2.43 [1.14, 5.17]），尤其是混合细胞型。对于所有类型的淋巴瘤，我们观察到与高危妊娠相关的指标（包括保胎治疗、胎儿骨盆比例失调和早产史）会使风险增加约两倍。NHL 风险增加两倍与胎膜早破并发症相关（OR 和 95% CI 2.18 [1.12, 4.25]），HL 与羊水胎粪污染相关（OR 和 95% CI 2.55 [1.01, 6.43]）。
这些数据支持先前报道的西班牙裔与 HL 之间的关联，并提示与妊娠相关的因素，如宫内感染和与早产相关的因素，可能与淋巴瘤的发病机制有关。
