Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York; Fire Department of the City of New York (FDNY), Brooklyn, New York.
Ann Allergy Asthma Immunol. 2022 Dec;129(6):769-775. doi: 10.1016/j.anai.2022.07.012. Epub 2022 Jul 21.
Individuals with very low immunoglobulin E (IgE) levels have a high risk of developing malignancy. Previous studies have revealed that World Trade Center (WTC) responders exposed to carcinogens have an elevated risk of some cancers.
To evaluate the association between low-serum IgE levels and cancer development in WTC-exposed responders.
IgE levels were measured in 1851 WTC responders after September 11, 2001. This is the first pilot study in humans comparing the odds of developing cancer in this high-risk population, between the "low-IgE" (IgE in the lowest third percentile) vs "non-low-IgE" participants.
A significantly higher proportion of hematologic malignancies was found in low-IgE (4/55, 7.3%) compared with non-low-IgE (26/1796, 1.5%, P < .01) responders. The proportion of solid tumors were similar in both groups (5.5% vs 11.4%, P > .05). After adjustment for relevant confounders (race, sex, age at blood draw, WTC arrival time, smoking status), the low-IgE participants had 7.81 times greater odds (95% confidence interval, 1.77-29.35) of developing hematologic cancer when compared with non-low-IgE participants. The hematologic cancers found in this cohort were leukemia (n = 1), multiple myeloma (n = 1), and lymphoma (n = 2). No statistical significance was found when estimating the odds ratio for solid tumors in relation to IgE levels.
WTC responders with low serum IgE levels had the highest odds of developing hematologic malignancies. This hypothesis-generating study suggests that low serum IgE levels might be associated with the development of specific malignancies in at-risk individuals exposed to carcinogens. Larger, multicenter studies with adequate follow-up of individuals with different IgE levels are needed to better evaluate this relationship.
免疫球蛋白 E（IgE）水平极低的个体患恶性肿瘤的风险很高。先前的研究表明，接触致癌物质的世界贸易中心（WTC）救援人员患某些癌症的风险增加。
评估 WTC 暴露救援人员低血清 IgE 水平与癌症发展之间的关系。
在 2001 年 9 月 11 日之后，对 1851 名 WTC 救援人员测量了 IgE 水平。这是第一项在高危人群中比较低 IgE（IgE 在最低三分之一百分位）与非低 IgE 参与者患癌症几率的人类 pilot 研究。
低 IgE（4/55，7.3%）组与非低 IgE（26/1796，1.5%）组相比，血液恶性肿瘤的比例明显更高（P<.01）。两组的实体瘤比例相似（5.5%比 11.4%，P>.05）。在校正了相关混杂因素（种族、性别、采血时年龄、WTC 到达时间、吸烟状况）后，与非低 IgE 参与者相比，低 IgE 参与者患血液恶性肿瘤的几率高 7.81 倍（95%置信区间，1.77-29.35）。该队列中发现的血液癌包括白血病（n=1）、多发性骨髓瘤（n=1）和淋巴瘤（n=2）。当估计 IgE 水平与实体瘤之间的比值比时，未发现统计学意义。
血清 IgE 水平较低的 WTC 救援人员患血液恶性肿瘤的几率最高。这项产生假说的研究表明，血清 IgE 水平较低可能与接触致癌物质的高危个体中特定恶性肿瘤的发展有关。需要更大规模、多中心的研究，对不同 IgE 水平的个体进行充分随访，以更好地评估这种关系。
