Wang Sophia S, Flowers Christopher R, Kadin Marshall E, Chang Ellen T, Hughes Ann Maree, Ansell Stephen M, Feldman Andrew L, Lightfoot Tracy, Boffetta Paolo, Melbye Mads, Lan Qing, Sampson Joshua N, Morton Lindsay M, Zhang Yawei, Weisenburger Dennis D
Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
J Natl Cancer Inst Monogr. 2014 Aug;2014(48):66-75. doi: 10.1093/jncimonographs/lgu012.
Accounting for 10%-15% of all non-Hodgkin lymphomas in Western populations, peripheral T-cell lymphomas (PTCL) are the most common T-cell lymphoma but little is known about their etiology. Our aim was to identify etiologic risk factors for PTCL overall, and for specific PTCL subtypes, by analyzing data from 15 epidemiologic studies participating in the InterLymph Consortium.
A pooled analysis of individual-level data for 584 histologically confirmed PTCL cases and 15912 controls from 15 case-control studies conducted in Europe, North America, and Australia was undertaken. Data collected from questionnaires were harmonized to permit evaluation of a broad range of potential risk factors. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression.
Risk factors associated with increased overall PTCL risk with a P value less than .05 included: a family history of hematologic malignancies (OR = 1.92, 95% CI = 1.30 to 2.84); celiac disease (OR = 17.8, 95% CI = 8.61 to 36.79); eczema (OR = 1.41, 95% CI = 1.07 to 1.85); psoriasis (OR = 1.97, 95% CI = 1.17 to 3.32); smoking 40 or more years (OR = 1.92, 95% CI = 1.41 to 2.62); and employment as a textile worker (ever) (OR = 1.58, 95% CI = 1.05 to 2.38) and electrical fitter (ever) (OR = 2.89, 95% CI = 1.41 to 5.95). Exposures associated with reduced overall PTCL risk included a personal history of allergies (OR = 0.69, 95% CI = 0.54 to 0.87), alcohol consumption (ever) (OR = 0.64, 95% CI = 0.49 to 0.82), and having ever lived or worked on a farm (OR = 0.72, 95% CI = 0.55% to 0.95%). We also observed the well-established risk elevation for enteropathy-type PTCL among those with celiac disease in our data. Conclusions Our pooled analyses identified a number of new potential risk factors for PTCL and require further validation in independent series.
在外周T细胞淋巴瘤(PTCL)占西方人群所有非霍奇金淋巴瘤的10%-15%,是最常见的T细胞淋巴瘤,但其病因知之甚少。我们的目的是通过分析参与国际淋巴瘤联盟的15项流行病学研究的数据,确定PTCL总体以及特定PTCL亚型的病因危险因素。
对欧洲、北美和澳大利亚进行的15项病例对照研究中584例经组织学确诊的PTCL病例和15912例对照的个体水平数据进行汇总分析。从问卷中收集的数据进行了统一处理,以评估广泛的潜在危险因素。使用逻辑回归计算比值比(OR)和95%置信区间(CI)。
与总体PTCL风险增加相关且P值小于0.05的危险因素包括:血液系统恶性肿瘤家族史(OR = 1.92,95%CI = 1.30至2.84);乳糜泻(OR = 17.8,95%CI = 8.61至36.79);湿疹(OR = 1.41,95%CI = 1.07至1.85);银屑病(OR = 1.97,95%CI = 1.17至3.32);吸烟40年或更长时间(OR = 1.92,95%CI = 1.41至2.62);曾从事纺织工人工作(OR = 1.58,95%CI = 1.05至2.38)和曾从事电气装配工工作(OR = 2.89,95%CI = 1.41至5.95)。与总体PTCL风险降低相关的暴露因素包括个人过敏史(OR = 0.69,95%CI = 0.54至0.87)、饮酒(OR = 0.64,95%CI = 0.49至0.82)以及曾在农场生活或工作(OR = 0.72,95%CI = 0.55%至0.95%)。我们还在数据中观察到乳糜泻患者中肠病型PTCL风险的显著升高。结论我们的汇总分析确定了一些新的PTCL潜在危险因素,需要在独立队列中进一步验证。