Cuzick J, De Stavola B
Department of Mathematics, Statistics and Epidemiology, Imperial Cancer Research Fund, London, UK.
Br J Cancer. 1988 May;57(5):516-20. doi: 10.1038/bjc.1988.118.
A total of 399 patients with multiple myeloma and an equal number of match controls were interviewed about factors possibly related to the causes of their disease. Factors studied included occupation, chemical exposure, radiation exposure, prior diseases, immunizations, chronic infections and markers for defects in immune regulation. A strong risk associated with agriculture/food processing was observed (RR = 1.8, P = 0.002). The risk could not be restricted to those exposed to animals or meat products, or those exposed to pesticides. Significant excesses were also noted for reported exposures to chemicals and gases/fumes, but no specific agent or group of agents could be identified. Cases had fewer tonsillectomies above the age of 10 (P = 0.01). A large excess of shingles (herpes zoster) was observed in cases (P less than 0.001), but most of the excess cases occurred within 10 years of diagnosis, suggesting this was a preclinical manifestation of disease rather than a cause of it.
对总共399名多发性骨髓瘤患者以及数量相等的匹配对照者进行了访谈，询问了可能与他们疾病病因相关的因素。所研究的因素包括职业、化学物质暴露、辐射暴露、既往疾病、免疫接种、慢性感染以及免疫调节缺陷标志物。观察到与农业/食品加工相关的强烈风险（相对危险度=1.8，P=0.002）。该风险不能局限于接触动物或肉类产品的人群，也不能局限于接触杀虫剂的人群。报告接触化学物质和气体/烟雾的情况也显著过量，但无法确定具体的某种或某类物质。病例组中10岁以上进行扁桃体切除术的人数较少（P=0.01）。在病例组中观察到带状疱疹（水痘-带状疱疹病毒）大量过量（P<0.001），但大多数过量病例发生在诊断后的10年内，这表明这是疾病的一种临床前表现而非病因。
