Knox E G, Marshall T, Barling R
J Epidemiol Community Health. 1984 Mar;38(1):12-6. doi: 10.1136/jech.38.1.12.
Data from the United Kingdom on childhood leukaemia and childhood cancer in twins and from the United States on leukaemia in twins are analysed by a new method. The method distinguishes determinants occurring before the stage of pregnancy corresponding with the cleavage of MZ pairs, from determinants occurring after this point. It derives estimates of the frequencies of each class of determinant. Different aetiological models are characterised by particular combinations of frequencies, and can thus be identified. The results of the analysis suggest that the major determinants of childhood leukaemia, and possibly of the solid cancers as well, operate before the time of cleavage. They operate either on the early zygote or its component germ cells. These early determinants are not, however, sufficient causes and require combination with postcleavage determinants, which subsequently occur in about a quarter of all children, before leukaemia can ensue.
英国有关双胞胎儿童白血病和儿童癌症的数据以及美国有关双胞胎白血病的数据,采用一种新方法进行了分析。该方法区分了在与单卵双胞胎分裂相对应的怀孕阶段之前出现的决定因素和在此之后出现的决定因素。它得出了每类决定因素频率的估计值。不同的病因模型具有特定的频率组合特征,因此可以识别。分析结果表明,儿童白血病的主要决定因素,可能还有实体癌的主要决定因素,在分裂时之前就起作用。它们要么作用于早期受精卵,要么作用于其组成的生殖细胞。然而,这些早期决定因素并非充分病因,在白血病能够发生之前,需要与分裂后决定因素相结合,而分裂后决定因素约在所有儿童中的四分之一中随后出现。