Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD.
Department of Clinical Epidemiology, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark.
Int J Cancer. 2018 Aug 15;143(4):767-772. doi: 10.1002/ijc.31354. Epub 2018 Mar 26.
Increased adult stature has been associated with risk of testicular germ cell tumors (TGCT) in a number of studies. Whether childhood stature is also associated with TGCT is unclear as no studies of measured childhood height and TGCT have been reported. Thus, associations between TGCT in adulthood and childhood height and growth between ages 7 and 13 years were examined in a cohort from the Copenhagen School Health Records Register. Analyses included 162,607 boys born during the years 1930-1989. Development of TGCT was determined via linkage to the Danish Cancer Registry. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression. Between 1968 and 2014, 782 TGCT were diagnosed. Childhood height, per one unit increase in z-score, was associated with risk of TGCT, with HRs ranging from 1.11 (95%CI 1.03-1.20) at age 7 to 1.09 (95%CI = 1.01-1.18) at age 13. In a categorical analysis, the shortest boys were at the lowest risk of developing TGCT. Results varied little by TGCT histology (seminoma and nonseminoma). Growth between ages 7 and 13 years was not associated with risk. These findings suggest that risk of TGCT in adulthood was already determined by age 7 years. Although the mechanism requires further investigation, these results provide additional evidence that risk of TGCT is determined at a young age, thus suggesting that additional investigation of early life factors is warranted.
在多项研究中,成年人身高的增加与睾丸生殖细胞肿瘤 (TGCT) 的风险相关。由于尚无关于测量儿童身高与 TGCT 的研究报告,因此儿童身高是否也与 TGCT 相关尚不清楚。因此,在哥本哈根学校健康记录登记处的队列中研究了成年 TGCT 与儿童身高和 7 至 13 岁之间生长之间的关联。分析包括 1930 年至 1989 年期间出生的 162607 名男孩。通过与丹麦癌症登记处的链接确定 TGCT 的发展。使用 Cox 比例风险回归计算风险比 (HR) 和 95%置信区间 (CI)。在 1968 年至 2014 年间,诊断出 782 例 TGCT。儿童身高每增加一个单位的 z 分数,与 TGCT 的风险相关,HR 范围为 7 岁时的 1.11(95%CI 1.03-1.20)至 13 岁时的 1.09(95%CI = 1.01-1.18)。在分类分析中,最矮的男孩 TGCT 发病风险最低。结果因 TGCT 组织学(精原细胞瘤和非精原细胞瘤)而异。7 至 13 岁之间的生长与风险无关。这些发现表明,成年期 TGCT 的风险早在 7 岁时就已确定。尽管该机制需要进一步研究,但这些结果提供了额外的证据表明 TGCT 的风险是在年轻时确定的,因此表明有必要进一步研究生命早期的因素。