Manns A, Cleghorn F R, Falk R T, Hanchard B, Jaffe E S, Bartholomew C, Hartge P, Benichou J, Blattner W A
Epidemiology and Biostatistics Program, National Cancer Institute, Rockville, Maryland 20852.
Lancet. 1993 Dec 11;342(8885):1447-50. doi: 10.1016/0140-6736(93)92931-i.
Human T-cell lymphotropic virus type I (HTLV-I) has been implicated in the aetiology of adult T-cell leukaemia/lymphoma in Japan and elsewhere, particularly the Caribbean. We have carried out parallel case-control studies in Jamaica and in Trinidad and Tobago to quantify the role of HTLV-I in the development of non-Hodgkin lymphoma (NHL). 135 cases of NHL were enrolled in Jamaica and 104 in Trinidad and Tobago. Controls were selected from patients treated in the same wards or clinics at the same time as the cases. Overall, patients with NHL were 10 times more likely than were controls to be seropositive for HTLV-I (Jamaica odds ratio 10.3 [95% CI 6.0-18.0], Trinidad and Tobago 14.4 [7.6-27.2]). In both countries the association between NHL and HTLV-I was greatest for T-cell lymphomas (18.3 [9.5-35.6] and 63.3 [25-167]). Among T-cell lymphomas especially, there was no significant difference between men and women in the association between NHL and HTLV-I, but there was a significant inverse relation between age and likelihood of HTLV-I seropositivity. B-cell lymphomas were predominant in the older age groups and were not associated with HTLV-I seropositivity. These findings are consistent with the hypothesis that early life exposure to HTLV-I is important for risk of subsequent ATL. Prevention of vertical transmission of HTLV-I could reduce by 70-80% cases of NHL in people under 60 years in this region.
I型人类嗜T细胞病毒（HTLV-I）被认为与日本及其他地区，尤其是加勒比地区的成人T细胞白血病/淋巴瘤的病因有关。我们在牙买加和特立尼达和多巴哥开展了平行病例对照研究，以量化HTLV-I在非霍奇金淋巴瘤（NHL）发病中的作用。牙买加纳入了135例NHL病例，特立尼达和多巴哥纳入了104例。对照从与病例同时在同一病房或诊所接受治疗的患者中选取。总体而言，NHL患者HTLV-I血清阳性的可能性是对照组的10倍（牙买加优势比10.3 [95%可信区间6.0 - 18.0]，特立尼达和多巴哥14.4 [7.6 - 27.2]）。在这两个国家，NHL与HTLV-I之间的关联在T细胞淋巴瘤中最为显著（分别为18.3 [9.5 - 35.6]和63.3 [25 - 167]）。特别是在T细胞淋巴瘤中，NHL与HTLV-I之间的关联在男性和女性之间没有显著差异，但年龄与HTLV-I血清阳性可能性之间存在显著的负相关。B细胞淋巴瘤在老年人群中占主导地位，且与HTLV-I血清阳性无关。这些发现与以下假设一致，即早年接触HTLV-I对随后发生成人T细胞白血病（ATL）的风险很重要。预防HTLV-I的垂直传播可使该地区60岁以下人群的NHL病例减少70 - 80%。
