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草甘膦的使用与非霍奇金淋巴瘤主要组织学亚型的关系:北美汇集项目的研究结果。

Glyphosate use and associations with non-Hodgkin lymphoma major histological sub-types: findings from the North American Pooled Project.

机构信息

Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada, M5T 3M7.

出版信息

Scand J Work Environ Health. 2019 Nov 1;45(6):600-609. doi: 10.5271/sjweh.3830. Epub 2019 Jun 27.

Abstract

Objectives Some epidemiological studies have suggested positive associations between glyphosate use and non-Hodgkin lymphoma (NHL), but evidence is inconsistent and few studies could evaluate histological sub-types. Here, associations between glyphosate use and NHL incidence overall and by histological sub-type were evaluated in a pooled analysis of case-control studies. Methods The analysis included 1690 NHL cases [647 diffuse large B-cell lymphoma (DLBCL), 468 follicular lymphoma (FL), 171 small lymphocytic lymphoma (SLL), and 404 other sub-types] and 5131 controls. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for NHL overall and sub-types with self-reported ever/never, duration, frequency, and lifetime-days of glyphosate use. Results Subjects who ever used glyphosate had an excess of NHL overall (OR 1.43, 95% CI 1.11-1.83). After adjustment for other pesticides, the OR for NHL overall with "ever use" was 1.13 (95% CI 0.84-1.51), with a statistically significant association for handling glyphosate >2 days/year (OR 1.73, 95% CI 1.02-2.94, P-trend=0.2). In pesticide-adjusted sub-type analyses, the ordinal measure of lifetime-days was statistically significant (P=0.03) for SLL, and associations were elevated, but not statistically significant, for ever years or days/year of use. Handling glyphosate >2 days/year had an excess of DLBCL (OR 2.14, 95% CI 1.07-4.28; P-trend=0.2). However, as with the other sub-types, consistent patterns of association across different metrics were not observed. Conclusions There was some limited evidence of an association between glyphosate use and NHL in this pooled analysis. Suggestive associations, especially for SLL, deserve additional attention.

摘要

目的 一些流行病学研究表明,草甘膦的使用与非霍奇金淋巴瘤(NHL)之间存在正相关关系,但证据并不一致,而且很少有研究能够评估组织学亚型。在这里,通过病例对照研究的荟萃分析,评估了草甘膦使用与 NHL 总发病率以及与组织学亚型的相关性。

方法 该分析包括 1690 例 NHL 病例[647 例弥漫性大 B 细胞淋巴瘤(DLBCL),468 例滤泡性淋巴瘤(FL),171 例小淋巴细胞淋巴瘤(SLL)和 404 例其他亚型]和 5131 例对照。使用逻辑回归来估计 NHL 总发病率和组织学亚型的调整后比值比(OR)和 95%置信区间(CI),包括自我报告的使用过/未使用过、使用时长、使用频率和使用终生天数。

结果 曾经使用过草甘膦的受试者 NHL 总发病率偏高(OR 1.43,95%CI 1.11-1.83)。在调整其他农药后,“曾经使用”与 NHL 总发病率的 OR 为 1.13(95%CI 0.84-1.51),与每年处理草甘膦>2 天具有统计学显著相关性(OR 1.73,95%CI 1.02-2.94,P-trend=0.2)。在调整农药的亚型分析中,终生天数的有序测量具有统计学意义(P=0.03),与使用年限或每年使用天数的相关性升高,但无统计学意义。每年处理草甘膦>2 天与 DLBCL 发病率偏高有关(OR 2.14,95%CI 1.07-4.28;P-trend=0.2)。但是,与其他亚型一样,不同指标之间的关联模式并未一致观察到。

结论 在这项荟萃分析中,草甘膦的使用与 NHL 之间存在一些有限的关联证据。特别是对于 SLL,有一些提示性的关联值得进一步关注。

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