Inskip P D, Mellemkjaer L, Gridley G, Olsen J H
Department of Veterinary Anatomy and Public Health, College of Veterinary Medicine, Texas A&M University, College Station 77843, USA.
Cancer Causes Control. 1998 Jan;9(1):109-16. doi: 10.1023/a:1008861722901.
The incidence of brain and other intracranial tumors following head trauma was evaluated in a cohort of 228,055 Danish residents hospitalized because of concussion, fractured skull, or other head injury between 1977 and 1992 and followed for an average of eight years (maximum, 17 years). Traffic accidents, falls, and sports-related incidents were the usual causes of the injury. Malignant and benign neoplasms were identified by linking the study roster with records of the Danish Cancer Registry for the years 1977 to 1993. This approach precludes differential reporting of injuries by study participants as an explanation for any associations seen. Intracranial tumors of the nervous system occurred more often than expected based on incidence rates for the Danish population; however, most of the excess occurred during the first year after the injury and likely was due to the detection of tumors that were present before the injury occurred. Excluding the first year of follow-up, the standardized incidence ratio (SIR) was 1.15 (95 percent confidence interval [CI] = 0.99-1.32). The same general temporal pattern was seen for the major subtypes of brain tumor as for all types combined. SIRs after the first year were 1.0 for glioma (CI = 0.8-1.2), 1.2 for meningioma (CI = 0.8-1.7), and 0.8 for neurilemmoma (CI = 0.4-1.7). However, hemangioblastoma and hemangioma were more frequent than expected, based on 15 cases (SIR = 2.6, CI = 1.4-4.2). Results indicate that head trauma causes, at most, a small increase in the overall risk of brain tumors during the ensuing 15 years; however, a possible association with intracranial vascular tumors warrants further evaluation.
在1977年至1992年期间，对228,055名因脑震荡、颅骨骨折或其他头部损伤而住院的丹麦居民进行了队列研究，以评估头部外伤后脑及其他颅内肿瘤的发病率，并对他们进行了平均八年（最长17年）的随访。交通事故、跌倒和与运动相关的事件是常见的受伤原因。通过将研究名册与1977年至1993年丹麦癌症登记处的记录相链接，确定了恶性和良性肿瘤。这种方法排除了研究参与者对损伤的差异报告作为所观察到的任何关联的解释。基于丹麦人群的发病率，神经系统颅内肿瘤的发生频率高于预期；然而，大多数超额发生在受伤后的第一年，可能是由于发现了受伤前就已存在的肿瘤。排除随访的第一年，标准化发病率（SIR）为1.15（95%置信区间[CI]=0.99 - 1.32）。脑肿瘤的主要亚型与所有类型综合起来的情况呈现相同的总体时间模式。第一年之后，胶质瘤的SIR为1.0（CI = 0.8 - 1.2），脑膜瘤为1.2（CI = 0.8 - 1.7），神经鞘瘤为0.8（CI = 0.4 - 1.7）。然而，基于15例病例，血管母细胞瘤和血管瘤比预期更频繁（SIR = 2.6，CI = 1.4 - 4.2）。结果表明，头部外伤在随后的15年中最多只会使脑肿瘤的总体风险略有增加；然而，与颅内血管肿瘤的可能关联值得进一步评估。
