Yang Yanping, Yin Li, Liu Qianwei, Sun Jiangwei, Adami Hans-Olov, Ye Weimin, Zhang Zhe, Fang Fang
Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education/Guangxi Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Nanning 530021, China.
Cancers (Basel). 2022 Aug 5;14(15):3804. doi: 10.3390/cancers14153804.
To assess the association of hospital-treated infections with the subsequent risk of two Epstein-Barr virus (EBV)-related malignancies, namely Hodgkin's lymphoma (HL) and nasopharyngeal carcinoma (NPC).
We performed a nested case-control study based on several national registers in Sweden. Cases were individuals newly diagnosed with HL or NPC during 1994-2016 in Sweden, according to the Swedish Cancer Register. For each case, we randomly selected five controls individually matched to the case on sex and year of birth from the general Swedish population. Hospital-treated infections (i.e., infections requiring either inpatient or outpatient hospital care) were identified from the Swedish Patient Register. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of HL and NPC, in relation to hospital-treated infections, after adjustment for age, sex, calendar period, educational achievement, and region of residence.
The study included a total of 890 cases of HL and 306 cases of NPC. A hospital-treated infection three years ago or earlier was associated with a higher risk of HL (OR = 1.49, 95%CI: 1.26-1.75) as well as NPC (OR = 1.36; 95%CI: 1.01-1.83). The positive association was noted for both bacterial and viral infections and primarily for respiratory and skin infections. A monotonous dose-response relationship was found between a number of hospital-treated infections and the risk of HL ( = 0.02) but less compelling for NPC ( = 0.06). Using a 5-year lag time rendered similar results (OR = 1.43, 95%CI: 1.21-1.70 for HL; OR = 1.43, 95%CI: 1.05-1.95 for NPC).
These findings suggest that infections requiring hospital treatment might contribute to the carcinogenesis of malignancies potentially related to EBV.
评估医院治疗的感染与随后两种与爱泼斯坦-巴尔病毒（EBV）相关的恶性肿瘤，即霍奇金淋巴瘤（HL）和鼻咽癌（NPC）风险之间的关联。
我们基于瑞典的几个国家登记处进行了一项巢式病例对照研究。根据瑞典癌症登记处的数据，病例为1994年至2016年期间在瑞典新诊断为HL或NPC的个体。对于每个病例，我们从瑞典普通人群中随机选择五个在性别和出生年份上与病例个体匹配的对照。医院治疗的感染（即需要住院或门诊医院护理的感染）通过瑞典患者登记处确定。在调整年龄、性别、日历期、教育程度和居住地区后，使用条件逻辑回归来估计HL和NPC与医院治疗的感染相关的比值比（OR）和95%置信区间（CI）。
该研究共纳入890例HL病例和306例NPC病例。三年前或更早的医院治疗感染与HL风险较高相关（OR = 1.49，95%CI：1.26 - 1.75）以及NPC风险较高相关（OR = 1.36；95%CI：1.01 - 1.83）。细菌和病毒感染均呈现正相关，主要是呼吸道和皮肤感染。医院治疗感染的数量与HL风险之间发现了单调的剂量反应关系（P = 0.02），但对NPC的关系不太明显（P = 0.06）。使用5年的滞后时间得出了类似的结果（HL的OR = 1.43，95%CI：1.21 - 1.70；NPC的OR = 1.43，95%CI：1.05 - 1.95）。
这些发现表明，需要医院治疗的感染可能有助于与EBV潜在相关的恶性肿瘤的致癌作用。
