Petridou Eleni Th, Sergentanis Theodoros N, Skalkidou Alkistis, Antonopoulos Constantine N, Dessypris Nick, Svensson Tobias, Stephansson Olof, Kieler Helle, Smedby Karin E
aDepartment of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, National and Kapodistrian University of Athens, Athens Greece bDepartment of Women's and Children's Health, Uppsala University, Uppsala cUnit of Clinical Epidemiology, Department of Medicine, Centre for Pharmacoepidemiology dDepartment of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Solna, Sweden.
Eur J Cancer Prev. 2015 Nov;24(6):535-41. doi: 10.1097/CEJ.0000000000000122.
This Swedish nationwide cohort study aims to examine the role of maternal characteristics (maternal age, education, smoking, BMI, diabetes, and preeclampsia) and multiple intrauterine growth measures on the risk of childhood lymphomas. A total of 3 444 136 singleton live births registered in the Swedish Medical Birth Register were analyzed, among whom there were 515 incident non-Hodgkin lymphoma (NHL) cases and 169 Hodgkin lymphoma (HL) cases aged 0-14 years at diagnosis (1973-2007) identified through linkage with the Swedish Cancer Register. Proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) of NHL and HL. Male sex (HR=2.00, 95% CI: 1.66-2.41), older maternal age (HR=1.03, 95% CI: 1.00-1.06, per 1-year increase), and large for gestational age compared with appropriate for gestational age (AGA) birth weight (HR=1.83, 95% CI: 1.20-2.79) were correlated with the risk of NHL; of note, in subanalysis by sex, the latter association was confined to girls (HR=3.37, 95% CI: 1.90-5.97, Pinteraction by sex=0.008). The risk of childhood HL overall was more evident among boys (HR=2.03, 95% CI: 1.46-2.81), whereas indices of accelerated fetal growth were not convincingly associated with the risk of HL. Apart from the established association with sex, the findings point to accelerated intrauterine growth as a risk factor for childhood NHL that may differ by sex. Given the rarity of this condition at birth, however, further studies with more elaborate indices are needed to conclude on its association with rare diseases such as HL.
这项瑞典全国性队列研究旨在探讨母亲特征（母亲年龄、教育程度、吸烟、体重指数、糖尿病和先兆子痫）以及多种宫内生长指标对儿童淋巴瘤风险的影响。对瑞典医疗出生登记处登记的3444136例单胎活产进行了分析，其中通过与瑞典癌症登记处的数据链接，确定了515例确诊时年龄在0至14岁之间的非霍奇金淋巴瘤（NHL）新发病例和169例霍奇金淋巴瘤（HL）病例（1973 - 2007年）。采用比例风险模型来估计NHL和HL的风险比（HR）及95%置信区间（95%CI）。男性（HR = 2.00，95%CI：1.66 - 2.41）、母亲年龄较大（HR = 1.03，95%CI：1.00 - 1.06，每增加1岁）以及与适于胎龄（AGA）出生体重相比为大于胎龄（LGA）出生体重（HR = 1.83，95%CI：1.20 - 2.79）与NHL风险相关；值得注意的是，在按性别进行的亚组分析中，后一种关联仅限于女孩（HR = 3.37，95%CI：1.90 - 5.97，性别交互作用P = 0.008）。儿童HL的总体风险在男孩中更为明显（HR = 2.03，95%CI：1.46 - 2.81），而胎儿生长加速指标与HL风险之间的关联并不明确。除了已确定的与性别的关联外，研究结果表明宫内生长加速是儿童NHL的一个风险因素，且可能因性别而异。然而，鉴于这种情况在出生时较为罕见，需要进一步开展使用更精细指标的研究，以确定其与HL等罕见疾病的关联。
