Lambe M, Hsieh C C, Tsaih S W, Adami J, Glimelius B, Adami H O
Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden.
Cancer Epidemiol Biomarkers Prev. 1998 Sep;7(9):831-4.
The causes of Hodgkin's disease remain incompletely known, but a higher incidence in men than in women has prompted an interest in the role of female sex hormones and reproductive history. Available epidemiological data are, however, contradictory. We analyzed possible associations between parity, age at first birth, and the risk of developing Hodgkin's disease by a linkage between the Swedish Cancer Register and a nationwide Fertility Register. Among women born between 1925 and 1972, 917 cases with Hodgkin's disease and concomitant fertility information were identified. For each case patient, five age-matched controls were randomly selected among women in the Fertility Register. Conditional logistic regression was used to estimate odds ratios of Hodgkin's disease associated with a birth. We found a slightly and nonsignificantly reduced risk of Hodgkin's disease in ever-parous compared with nulliparous women. Among parous women, the number of children was unrelated to risk, whereas there was some evidence of an increased risk with late age at first birth in women under age 45 at diagnosis. No clear temporal relations between childbearing and subsequent risk were discernible in any parity or age group. Although uncontrolled confounding might have affected our results, they do not indicate that hormonal or immunological changes associated with childbearing play a role in the development of Hodgkin's disease.
霍奇金淋巴瘤的病因仍未完全明确，但男性发病率高于女性这一现象引发了人们对女性性激素及生育史作用的关注。然而，现有的流行病学数据相互矛盾。我们通过瑞典癌症登记处与全国生育登记处的联动，分析了生育次数、初产年龄与患霍奇金淋巴瘤风险之间的可能关联。在1925年至1972年出生的女性中，共识别出917例患有霍奇金淋巴瘤且有生育信息的病例。对于每例病例患者，在生育登记处的女性中随机选取5名年龄匹配的对照。采用条件逻辑回归来估计与生育相关的霍奇金淋巴瘤的比值比。我们发现，与未生育女性相比，曾生育女性患霍奇金淋巴瘤的风险略有降低，但无统计学意义。在已生育女性中，子女数量与风险无关，而在诊断时年龄小于45岁的女性中，有证据表明初产年龄较大时风险增加。在任何生育次数或年龄组中，均未发现生育与后续风险之间存在明显的时间关系。尽管未控制的混杂因素可能影响了我们的结果，但这些结果并未表明与生育相关的激素或免疫变化在霍奇金淋巴瘤的发生中起作用。
