Williams A R, Weiss N S, Koepsell T D, Lyon J L, Swanson G M
Department of Epidemiology, University of Washington, Seattle 98195.
Cancer Res. 1989 Jul 15;49(14):4038-41.
Sixty-nine subjects with light chain myeloma were interviewed in a multicenter case-control study, and their responses were compared to those of 1683 controls selected from the general population of the same geographic areas. The interview was directed at the subject's history of exposure to a variety of chemical and infectious agents. Persons with a history of a medical implant had 2.2 times the risk of other persons (95% confidence interval = 0.9-5.8), a relative risk that increased with increasing time that the implant had been present. Alkali exposure that was deemed by the subject to be unusually heavy was associated with a relative risk of light chain myeloma of 7.8 (95% confidence interval = 1.7-35.3), while similarly defined exposure to carbon monoxide increased the risk by 6.1 times (95% confidence interval = 2.0-18.2). These findings differ from those obtained in our study of the more common forms of multiple myeloma and, while the differences are plausibly due only to chance given the large number of exposures investigated, they could be an indication that light chain myeloma is an etiologically distinct entity.
在一项多中心病例对照研究中，对69例轻链骨髓瘤患者进行了访谈，并将他们的回答与从同一地理区域的普通人群中选取的1683名对照者的回答进行了比较。访谈针对受试者接触各种化学和感染因子的病史。有医疗植入物病史的人患轻链骨髓瘤的风险是其他人的2.2倍（95%置信区间=0.9-5.8），且该相对风险随植入物存在时间的增加而增加。受试者认为异常大量的碱暴露与轻链骨髓瘤的相对风险为7.8相关（95%置信区间=1.7-35.3），而类似定义的一氧化碳暴露使风险增加6.1倍（95%置信区间=2.0-18.2）。这些发现与我们在对更常见形式的多发性骨髓瘤的研究中获得的结果不同，虽然鉴于所研究的暴露因素数量众多，这些差异可能仅由偶然因素导致，但它们可能表明轻链骨髓瘤是一种病因上不同的实体。
