Härö A S
Dev Biol Stand. 1986;58 ( Pt A):433-49.
The information concerning leukaemia in the Cancer Register in Finland was matched with a BCG vaccination index (FVI) constructed in 1946-49. Male birth year cohorts 1926-41 were analyzed by comparing observed/expected ratios. There were 422 cases of leukaemia (A59) in these cohorts during 1949-78 which was the follow-up period. The expected values were counted on the basis of experience of the whole population of included cohorts. There were approximately 533,000 persons in the cohorts studied. About 315,000 participated in the mass BCG vaccination campaign. 115,000 were tuberculin positive, 200,000 were negative and BCG vaccinated. The cohort analysis techniques were applied and the findings presented as Lexis diagrams. A sample of the population register was used in order to check the matching errors in FVI. Obviously, the presented number of participants is not quite reliable. This is understandable because the register had not been in use from 1953-77 and contact with the organizers is no longer possible. With correction factors the errors can be adjusted, at least to some extent. The register is functioning as expected in relation to general mortality and tuberculosis. The results indicate that there is no marked difference between naturally T. B. infected and BCG vaccinated persons. The participants seem to have considerably less cases of leukaemia than the non-participants of which a great deal are not infected or vaccinated. Structural weaknesses in the FVI do not allow firm conclusions to drawn. There is in any case so much evidence by age, by calendar year and by cohort that a hypothesis of the diminishing long term effects on leukaemia is justified. The interrelationships are long standing and were noticeable during the whole follow-up period about 30 years. It seems that there is no difference in the possible effect between different types of leukaemia. The structural weaknesses, like the real number of participants in the register can be corrected. The analysis can be broadened to cover females as well, which will also facilitate analysis by different types of leukaemia. The possible long standing effect of mycobacterial infections are discussed. Some strategies of further research are outlined.
芬兰癌症登记处中有关白血病的信息与1946 - 1949年构建的卡介苗接种指数（FVI）进行了匹配。通过比较观察值/期望值比率，对1926 - 1941年出生的男性队列进行了分析。在1949 - 1978年的随访期间，这些队列中有422例白血病（A59）病例。期望值是根据纳入队列的整个人口的经验计算得出的。所研究的队列中约有53.3万人。约31.5万人参加了大规模卡介苗接种运动。11.5万人结核菌素呈阳性，20万人呈阴性且接种了卡介苗。应用了队列分析技术，并将结果以莱克西斯图呈现。使用了人口登记样本以检查FVI中的匹配错误。显然，所呈现的参与者数量不太可靠。这是可以理解的，因为该登记册在1953 - 1977年未使用，且无法再与组织者取得联系。通过校正因子，这些错误至少可以在一定程度上得到调整。该登记册在一般死亡率和结核病方面按预期发挥作用。结果表明，自然感染结核病的人与接种卡介苗的人之间没有显著差异。参与者的白血病病例似乎比未参与者少得多，而未参与者中有大量人未感染或未接种疫苗。FVI的结构弱点不允许得出确凿结论。无论如何，按年龄、历年和队列来看，有如此多的证据表明白血病的长期影响在减弱这一假设是合理的。这种相互关系由来已久，在整个约30年的随访期间都很明显。不同类型白血病的可能影响似乎没有差异。登记册中的结构弱点，如参与者的实际数量可以得到校正。分析可以扩大到涵盖女性，这也将便于按不同类型白血病进行分析。讨论了分枝杆菌感染可能的长期影响。概述了一些进一步研究的策略。
