Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands.
Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Int J Cancer. 2016 May 15;138(10):2357-67. doi: 10.1002/ijc.29969. Epub 2016 Jan 8.
Prediagnostic serum/plasma concentrations of B-cell activation markers have been associated with future risk of B-cell lymphomas (BCL) in HIV-infected patients and in the general population. Current evidence for the general population is however limited and relies on relatively small numbers of observations, especially for specific histologies. We carried out a nested case-control study, including 218 BCL and 218 matched controls, within two prospective cohorts, to investigate the association between plasma levels of soluble (s)CD27 and sCD30 and future risk of BCL, and main histologic subtypes separately. To expand the evidence further, we performed meta-analyses of the published data on these associations from prospective studies among the general population. Our study revealed a significant relationship between sCD30 concentration and BCL risk (OR = 0.86, 1.53, 1.76, for the 2nd-4th quartiles respectively, p trend = 0.01). Similar increased risks were observed for diffuse large B-cell lymphoma and follicular lymphoma. Analyses of sCD27 blood concentrations did not show significant associations with BCL, (OR = 0.90, 1.26, 1.65 for the 2nd-4th quartiles, respectively, p trend = 0.17), but significant associations were observed for chronic lymphocytic leukaemia and for the group of "other BCL" subtypes. Our findings involving sCD30 were confirmed within our meta-analyses of five prospective cohorts, while results were more heterogeneous for sCD27 with the exception of CLL which was found consistently in all studies. Data to date suggest that chronic B-cell stimulation might be an important mechanism involved in B-cell lymphomagenesis both in HIV-infected and in the general population.
在 HIV 感染者和一般人群中,B 细胞激活标志物的预测前血清/血浆浓度与未来发生 B 细胞淋巴瘤(BCL)的风险相关。然而,目前针对一般人群的证据有限,并且依赖于相对较少的观察结果,尤其是对于特定的组织学类型。我们在两个前瞻性队列中开展了一项巢式病例对照研究,包括 218 例 BCL 和 218 例匹配对照,以研究血浆可溶性(s)CD27 和 sCD30 水平与未来发生 BCL 的风险以及主要组织学亚型之间的关系。为了进一步扩展证据,我们对来自一般人群的前瞻性研究中关于这些关联的已发表数据进行了荟萃分析。我们的研究表明,sCD30 浓度与 BCL 风险之间存在显著关系(第 2-4 四分位数的比值比分别为 0.86、1.53、1.76,趋势 p 值=0.01)。弥漫性大 B 细胞淋巴瘤和滤泡性淋巴瘤也观察到类似的风险增加。sCD27 血液浓度分析未显示与 BCL 显著相关(第 2-4 四分位数的比值比分别为 0.90、1.26、1.65,趋势 p 值=0.17),但与慢性淋巴细胞白血病和“其他 BCL”亚型组存在显著相关性。我们的发现涉及 sCD30,在我们对五个前瞻性队列的荟萃分析中得到了证实,而 sCD27 的结果则更加复杂,除了在所有研究中都发现的 CLL 外,没有一致性。目前的数据表明,慢性 B 细胞刺激可能是 HIV 感染者和一般人群中 B 细胞淋巴瘤发生的一个重要机制。