Preston-Martin S, Pogoda J M, Schlehofer B, Blettner M, Howe G R, Ryan P, Menegoz F, Giles G G, Rodvall Y, Choi N W, Little J, Arslan A
University of Southern California, Department of Preventive Medicine, USC/Norris Comprehensive Cancer Center, Los Angeles 90033-0800, USA.
Int J Epidemiol. 1998 Aug;27(4):579-86. doi: 10.1093/ije/27.4.579.
Increased brain tumour risk after head trauma suggested by case reports and clinical series has been previously studied epidemiologically with mixed results. An international multicentre case-control study investigated the role of head trauma from injury or sports participation in adult brain tumour risk.
In all, 1178 glioma and 330 meningioma cases were individually or frequency matched to 2236 controls. Only exposures that occurred at least 5 years before diagnosis and head injuries that received medical attention were considered.
Risk for ever having experienced a head injury was highest for male meningiomas (odds ratio [OR] = 1.5, 95% confidence interval [CI] : 0.9-2.6) but was lower for 'serious' injuries, i.e. those causing loss of consciousness, loss of memory or hospitalization (OR = 1.2, 95% CI: 0.6-2.3). Among male meningiomas, latency of 15 to 24 years significantly increased risk (OR = 5.4, 95% CI: 1.7-16.6), and risk was elevated among those who participated in sports most correlated with head injury (OR = 1.9, 95% CI: 0.7-5.3). Odds ratios were lower for male gliomas (OR = 1.2, 95% CI : 0.9-1.5 for any injury; OR = 1.1, 95% CI: 0.7-1.6 for serious injuries) and in females in general.
Evidence for elevated brain tumour risk after head trauma was strongest for meningiomas in men. Findings related to sports should be interpreted cautiously due to cultural variability in our data and our lack of complete data on physical exercise in general which appeared to be protective.
病例报告和临床系列研究表明头部外伤后患脑肿瘤的风险增加,此前已有流行病学研究,但结果不一。一项国际多中心病例对照研究调查了因受伤或参与运动导致的头部外伤在成 人脑肿瘤风险中的作用。
总共1178例胶质瘤病例和330例脑膜瘤病例与2236例对照进行个体匹配或频率匹配。仅考虑诊断前至少5年发生的暴露以及接受过医疗救治的头部损伤。
曾经历头部损伤的风险在男性脑膜瘤患者中最高(比值比[OR]=1.5,95%置信区间[CI]:0.9 - 2.6),但“严重”损伤(即导致意识丧失、失忆或住院的损伤)的风险较低(OR = 1.2,95% CI:0.6 - 2.3)。在男性脑膜瘤患者中,受伤后15至24年的潜伏期显著增加了风险(OR = 5.4,95% CI:1.7 - 16.6),并且在参与与头部损伤相关性最高的运动的人群中风险升高(OR = 1.9,95% CI:0.7 - 5.3)。男性胶质瘤患者的比值比更低(任何损伤的OR = 1.2,95% CI:0.9 - 1.5;严重损伤的OR = 1.1,95% CI:0.7 - 1.6),总体上女性也是如此。
头部外伤后患脑肿瘤风险升高的证据在男性脑膜瘤患者中最为明显。由于我们数据中的文化差异以及我们总体上缺乏关于体育锻炼的完整数据(体育锻炼似乎具有保护作用),与运动相关的研究结果应谨慎解读。