Department of Internal Medicine/Allergy-Immunology, Albert Einstein College of Medicine/Montefiore Medical Center.
Albert Einstein College of Medicine, Bronx, NY.
J Pediatr Hematol Oncol. 2021 May 1;43(4):e472-e477. doi: 10.1097/MPH.0000000000001898.
Immunoglobulin (Ig) E-deficient adults (IgE<2.5 kU/L) have increased susceptibility for developing malignancy. We evaluated the association between IgE deficiency and cancer diagnosis in children (age younger than 18 y), compared with those non-IgE-deficient (IgE≥2.5 kU/L).
Information about malignancy diagnosis were compared between 4 cohorts of children who had IgE levels measured at our institution: IgE-deficient (IgE<2.5 kU/L), normal IgE (2.5<IgE≥100 kU/L), high IgE (100≥IgE<1000 kU/L), very high IgE (IgE≥1000 kU/L).
Overall, 94/4586 (2%) children had IgE deficiency. A significantly higher malignancy rate was found in IgE-deficient children (3/94, 3.2%) compared with non-IgE-deficient cohort (13/4492, 0.3%, P<0.0001). Analysis of the groups with different IgE levels revealed a significantly higher rate of cancer in IgE-deficient children (3.2%) compared with those with normal (0.5%; odds ratio [OR]=7.84; 95% confidence interval [CI]: 1.94-31.61, P=0.004), high (0.2%; OR=25.80; 95% CI: 4.94-134.54, P=0.002), and very high IgE levels (0.2%; OR=42.17; 95% CI: 3.84-463.02, P<0.0001). All 3 IgE-deficient children had lymphoma. Malignancies in the other groups included lymphoma, leukemia, brain, liver, ovarian cancers.
Malignancy rate was higher in IgE-deficient children compared with those with normal, high, or very high IgE levels, supporting the hypothesis that IgE deficiency may be a marker for malignancy susceptibility in children. Larger, prospective studies are necessary to further evaluate this association.
免疫球蛋白 E 缺乏症成年人（IgE<2.5 kU/L）更容易发生恶性肿瘤。我们评估了 IgE 缺乏症与儿童（年龄小于 18 岁）癌症诊断之间的关联，将 IgE 缺乏症（IgE<2.5 kU/L）与非 IgE 缺乏症（IgE≥2.5 kU/L）进行比较。
比较了在我们机构测量 IgE 水平的 4 组儿童中恶性肿瘤诊断的信息：IgE 缺乏症（IgE<2.5 kU/L）、正常 IgE（2.5<IgE≥100 kU/L）、高 IgE（100≥IgE<1000 kU/L）、非常高 IgE（IgE≥1000 kU/L）。
总体而言，4586 名儿童中有 94 名（2%）存在 IgE 缺乏症。与非 IgE 缺乏组（4492 名中的 13 名，0.3%）相比，IgE 缺乏症儿童（3/94，3.2%）恶性肿瘤发生率明显更高（P<0.0001）。对不同 IgE 水平组的分析显示，IgE 缺乏症儿童（3.2%）癌症发生率明显高于正常组（0.5%；优势比[OR]=7.84；95%置信区间[CI]：1.94-31.61，P=0.004）、高组（0.2%；OR=25.80；95% CI：4.94-134.54，P=0.002）和非常高 IgE 水平组（0.2%；OR=42.17；95% CI：3.84-463.02，P<0.0001）。所有 3 名 IgE 缺乏症儿童均患有淋巴瘤。其他组的恶性肿瘤包括淋巴瘤、白血病、脑、肝、卵巢癌。
与正常、高、非常高 IgE 水平的儿童相比，IgE 缺乏症儿童的恶性肿瘤发生率更高，这支持 IgE 缺乏症可能是儿童恶性肿瘤易感性的标志物这一假说。需要更大规模的前瞻性研究来进一步评估这种关联。
