Lupatsch Judith E, Bailey Helen D, Lacour Brigitte, Dufour Christelle, Bertozzi Anne-Isabelle, Leblond Pierre, Faure-Conter Cécile, Pellier Isabelle, Freycon Claire, Doz François, Puget Stéphanie, Ducassou Stéphane, Orsi Laurent, Clavel Jacqueline
UMRS 1153, INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
UMRS 1153, INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l'enfant et de l'adolescent, Paris, France.
Cancer Epidemiol. 2018 Feb;52:1-9. doi: 10.1016/j.canep.2017.10.015. Epub 2017 Nov 10.
Few studies have investigated whether early infections and factors potentially related to early immune stimulation might be involved in the aetiology of childhood brain tumours (CBT). In this study, we investigated the associations between CBT with early day-care attendance, history of early common infections, atopic conditions (asthma/wheezing, eczema, allergic rhinitis), early farm residence/visits and contact with animals.
We pooled data from two nationwide French case-control studies, the ESCALE and ESTELLE studies. Children with a CBT diagnosed between 1 and 14 years of age were identified directly from the French National Registry of Childhood Cancers, while population controls were recruited from telephone subscribers. Odds-ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression adjusted for potential confounders.
The analyses included 469 cases and 2719 controls. We found no association between attending a day-care centre (OR: 0.9, 95%CI: 0.7-1.2) or having had repeated common infections (OR: 0.9, 95%CI: 0.7-1.2) in the first year of life and the risk of CBT. There was also no association with a history of asthma/wheezing (OR: 0.8, 95%CI: 0.56-1.1). Farm visits (OR: 0.6, 95%CI: 0.5-0.8) as well as contact with pets (OR: 0.8, 95%CI: 0.6-1.0) in the first year of life were inversely associated with CBT.
Our findings suggest a protective effect of early farm visits and contact with pets, but not with other markers of early immune stimulation. This might be related to immune stimulation but needs further investigation.
很少有研究调查早期感染以及可能与早期免疫刺激相关的因素是否参与儿童脑肿瘤（CBT）的病因。在本研究中，我们调查了CBT与早期日托出勤、早期常见感染史、特应性疾病（哮喘/喘息、湿疹、过敏性鼻炎）、早期居住在农场/前往农场及与动物接触之间的关联。
我们汇总了两项法国全国性病例对照研究（ESCALE和ESTELLE研究）的数据。1至14岁被诊断为CBT的儿童直接从法国国家儿童癌症登记处确定，而人群对照则从电话用户中招募。使用针对潜在混杂因素进行调整的逻辑回归估计比值比（OR）和95%置信区间（CI）。
分析纳入了469例病例和2719例对照。我们发现生命第一年参加日托中心（OR：0.9，95%CI：0.7 - 1.2）或有反复常见感染（OR：0.9，95%CI：0.7 - 1.2）与CBT风险之间无关联。哮喘/喘息史（OR：0.8，95%CI：0.56 - 1.1）也无关联。生命第一年前往农场（OR：0.6，95%CI：0.5 - 0.8）以及与宠物接触（OR：0.8，95%CI：0.6 - 1.0）与CBT呈负相关。
我们的研究结果表明早期前往农场和与宠物接触具有保护作用，但与其他早期免疫刺激标志物无关。这可能与免疫刺激有关，但需要进一步研究。
