Geographical and ecological analyses of childhood acute leukaemias and lymphomas in north-west England

Childhood leukaemias and lymphomas have been associated with exposure to environmental factors, including infections, which show geographical variation. This study examined the geographical distribution of the incidence of acute leukaemia and lymphoma using Manchester Children's Tumour Registry (MCTR) data 1976-2000. A total of 910 children were included, all of whom had histologically and/or cytologically verified leukaemia or lymphoma. At the time of their diagnoses, all the children were aged 0-14 years and were resident in the counties of Greater Manchester or Lancashire. Standardized morbidity ratios were calculated. Poisson regression was used to examine the relationship between incidence rates and small-area (census ward) population density, ethnic composition and deprivation index. There was a monotonic relationship between acute lymphoblastic leukaemia (ALL) incidence and population density (P = 0.05). Higher rates were seen in more densely populated areas. There was evidence for a monotonic relationship between the incidence of the mixed cellularity subtype of Hodgkin's disease (HD) and the Townsend deprivation score (P = 0.001). Markedly higher incidence was associated with greater levels of unemployment and household overcrowding. The results for ALL and mixed cellularity HD support the involvement of environmental factors, such as infections, in disease aetiology.     

Indoor environmental risk factors and childhood asthma: A case-control study in a subtropical area

This study examined the relation between indoor environmental factors and childhood asthma in a subtropical area. A hospital-based case-control study was performed in Kaohsiung, Taiwan, between July of 1995 and June of 1996. Eighty-six children seen in the out-patient clinic of our university hospital and who had a first-time diagnosis of asthma made by a pediatrician were the test group; 86 control subjects were selected from children attending the Childhood Orthopaedic Clinic in the same hospital and who had no previous diagnosis of asthma or asthma symptoms and no history of physician confirmed atopic diseases. The control subjects were matched with test case children on the basis of gender and age. Information was obtained from parents using a structured questionnaire. Of the many indoor environmental factors included in this study, only home dampness showed an association with asthma (adjusted odds ratio = 1.77; 95% confidence intervals, 1.24–2.53). We conclude that dampness in the home is a new public health risk factor related to asthma in subtropical areas. Pediatr Pulmonol. 1998; 26:120–124. © 1998 Wiley-Liss, Inc.     

Toxocariasis and childhood asthma: A case-control study

Objective: The objective of this study is to investigate the association between anti-Toxocara IgG seropositivity and asthma in children. Methods: This was a case-control study conducted in a university hospital in south Brazil between May 2012 and June 2013. Were recruited 208 children up to 12 years old of whom 156 had asthma (cases) and 52 did not have asthma (controls), with a case-control ratio of 3:1 matched by age. Children's parents or guardians were interviewed using a structured questionnaire with closed questions. Serology was performed using enzyme-linked immunosorbent assay (ELISA) with excretory-secretory antigen of Toxocara canis (TES). Results: The seroprevalence of IgG anti-T. canis antibodies was 12.8% in the cases and 7.7% in the controls. There was no significant association between seropositivity to T. canis and risk of asthma (adjusted odds ratio [OR]: 1.89, 95% CI: 0.52 to 6.89, p = 0.33). Household income < 2 minimum salaries, paternal school years < 9, allergic rhinitis in children, a positive family history of asthma and rhinitis and contact with cats were significantly associated with asthma, with adjusted ORs (95% CIs) of 3.05 (1.21 to 7.73), 2.83 (1.11 to 7.18), 10.5 (4.32 to 25.6), 2.65 (1.14 to 6.17), 2.49 (1.07 to 5.78) and 2.73 (1.03 to 7.27), respectively. Conclusions: This study did not find a statistically significant association between seropositivity to Toxocara sp. and risk of asthma in children. Low family income, low paternal education level, concomitant allergic rhinitis, family history of asthma and allergic rhinitis and contact with cats were independent factors associated with childhood asthma.     

Serological diagnosis of the antigenic markers of acute lymphatic leukaemias and non-Hodgkin lymphomas in childhood (author's transl)]

Leukaemia cells of 11 children with acute lymphatic leukaemias (ALL) and lymphoma cells of 4 children with lymphosarcoma (LS) were studied for the presence of T- and B-lymphocyte markers on their cell membranes. Spontaneous rosette formation (E-rosettes) of the malignant cells after adding sheep erythrocytes and the reaction with antithymocyteserum in cytotoxic test served as T-cell-markers and the surface immunoglobulins as B-cell-markers. The leukaemia cells of 5 ALL-patients with mediastinal tumours formed E-rosettes and reacted with the anti-thymocyte-serum. Six ALL-patients did not show these reactions. None of the ALL-patients had surface-immunoglobulins. Two of the 4 LS-children were E-rosette-positive, the cells of the other two LS-children contained surface immunoglobulins. There was a good correlation between the formation of E-rosettes and the reaction with the anti-thymocyte-serum. After absorption of the anti-thymocyte-serum with peripheral leukocytes it reacted with some of the E-positive lymphoblasts and thymocytes but not with normal peripheral T-lymphocytes. Anti-leukaemia-sera against the ALL-cells with T-cell markers of two patients after absorption with spleen cells did not react with peripheral lymphocytes but did effect lysis of thymocytes. Consequently, leukaemia cells which are E-rosette-positive possess a T-lymphocyte-associated antigen and a Thymus-associated antigen.     

Genetic variants in immunoregulatory genes and risk for childhood lymphomas

To investigate whether single nucleotide polymorphisms (SNPs) in key cytokine and innate immunity genes influence risk for childhood lymphomas, we genotyped 37 children with Hodgkin’s (HL) and 48 with non‐Hodgkin’s lymphoma (NHL), aged (1 month–14 yr), along with their 85 age‐ and gender‐matched controls suffering from mild medical conditions. Genotypic analysis was performed for 10 SNPs from nine genes with important role in immunoregulatory pathways (IL4, IL4R, IL6, IL10, IL12, IL18, TNFα, IFNγ, CD14). Analysis of SNPs genotypes revealed that the CD14 ?159 C>T polymorphism was associated with significantly increased risk for HL regarding both the CC and CT genotypes (OR_CC: 5.36; 95% CI, 1.30–22.14; P = 0.02, OR_CT: 3.76; 95% CI, 1.00–14.16; P = 0.05). An indicative association between IL18?137 G>C polymorphism with the CC genotype and NHL did not reach, however, statistical significance (OR_CC, 3.78; 95% CI, 0.87–16.38; P = 0.08). In conclusion, our findings suggest that genetic variation in the CD14–159 loci may be associated with childhood HL risk; these preliminary findings need to be further confirmed in sizeable multi‐centre studies along with determination of cytokines, which could provide an insight on the biologic basis underlying these findings.     

Moisture damage and childhood asthma: a population-based incident case-control study.

Most previous studies on the association between moisture damage and asthma have been cross-sectional and relied on self-reported exposure and health. The present authors studied the association by carrying out careful home inspections among new, clinically determined cases of asthma and controls. New cases of asthma aged 12-84 months (n = 121) were recruited prospectively and matched for year of birth, sex and living area with two randomly selected population controls (n = 241). Trained engineers visited all homes. Both cases and controls had lived >or=75% of their lifetime or the past 2 yrs in their current home. Risk of asthma increased with severity of moisture damage and presence of visible mould in the main living quarters but not in other areas of the house. Cases more often had damage in their bedroom. Associations were comparable for atopic and nonatopic asthma and for children aged >30 months or 相似文献   

Diabetes mellitus and cancer risk: a multisite case-control study

The association between a prior diagnosis of diabetes mellitus and cancer was examined in a large multisite case-control study based on interviews of 8220 white males and 6690 white females aged 30-89 who were admitted to Roswell Park Memorial Institute between 1957 and 1965 for the diagnosis and treatment of cancer. A prior history of diabetes mellitus as diagnosed by a physician was examined as a risk factor for cancer by conducting sex- and site-specific comparisons with a common control group of 2363 white males and 2475 white females who were admitted to the same hospital during the same years, but were found not to have cancer. The findings are consistent with previous studies which have shown diabetes to be a risk factor for cancer of the uterine corpus. A positive association was also noted between diabetes and cancer of the vulva and vagina. The evidence for excess estrogen levels as the underlying mechanism for increased risk of uterine and vulvo-vaginal cancer is reviewed. No consistent association between diabetes and pancreatic cancer was observed in this study, except when those cases in which diabetes was diagnosed within a year before the diagnosis of pancreatic cancer were included. This suggests that diabetes may be an early presenting sign of pancreatic cancer rather than a risk factor. A positive association between prior diagnosis of diabetes was noted for kidney cancer and nonmelanoma skin cancer in females only. No association between type of treatment (i.e. insulin, oral agents) and cancer risk was noted.     

Distribution of ABO blood groups in acute leukaemias and lymphomas

We studied the distribution of ABO blood groups in Hodgkins lymphoma, non-Hodgkins lymphoma, acute myeloid leukaemia and acute lymphoblastic leukaemia, in children up to the age of 12 years, in a hospital-based retrospective study. Blood group data were recorded from the case records of all the patients in a tertiary care centre with the diagnosis of Hodgkins lymphoma, non-Hodgkins lymphoma, acute myeloid leukaemia and acute lymphoblastic leukaemia, during the period 1987–1997. There were 63 Hodgkins lymphoma, 78 non-Hodgkins lymphoma, 116 acute myeloid leukaemia and 522 acute lymphoblastic leukaemia patients. We assessed the distribution of ABO blood groups and the difference in the distribution from the source population. In Hodgkins lymphoma, there were 45.6% [95% confidence interval (CI): 6.8–84.5] more patients with B blood group. In acute lymphoblastic leukaemia, there were 14.3% (95% CI: 3.2–25.2) more patients with O blood group. In Hodgkins lymphoma and non-Hodgkins lymphoma patients, there were 56.5% (95% CI: 19.9–85.4) and 52.9% (95% CI: 18.1–82.6) less patients with A blood group, respectively. This shows that the relationship between the ABO blood groups and haematological malignancies merits further investigation in a population-based prospective study. This is the first study of its kind in any Indian population.     

Mortality and the risk of malignancy in autoimmune liver diseases: a population-based study in Canterbury, New Zealand

Population-based quantitative data on the mortality and cancer incidence of autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC) are scarce. Our aim was to systematically investigate the survival and risk of malignancy on population-based cohorts of AIH, PBC, and PSC in Canterbury, New Zealand. Multiple case-finding methods were employed, including searches of all public and private, adult and pediatric outpatient clinics, hospital notes, laboratory, radiology, and pathology reports. Cases that fulfilled standardized diagnostic criteria were included. Kaplan-Meier survival estimates, standardized mortality ratios (SMR), and standard incidence ratios (SIR) for malignancy were calculated. A total of 130 AIH, 70 PBC, and 81 PSC patients were included contributing to 1,156, 625, and 613 person-years at risk, respectively. For AIH, PBC, and PSC cohorts, SMRs for all-cause mortality were 2.1 (95% confidence interval [CI] 1.4-3.1), 2.7 (95% CI 1.7-4.0), and 4.1 (95% CI 2.6-6.3), SMRs for hepatobiliary mortality were 42.3 (95% CI 20.3-77.9), 71.2 (95% CI 30.7-140.3), and 116.9 (95% CI 66.8-189.8), SIRs for all cancers were 3.0 (95% CI 2.0-4.3), 1.6 (95% CI 0.8-2.9), and 5.2 (95% CI 3.3-7.8), and SIRs for extrahepatic malignancy were 2.7 (95% CI 1.8-3.9), 1.6 (95% CI 0.8-2.9), and 3.0 (95% CI 1.6-5.1), respectively. CONCLUSION: This is the first population-based study to examine and compare the survival and cancer incidence in AIH, PBC, and PSC in the same population. The mortality for all three cohorts was significantly increased due to liver-related death, demonstrating the inadequacy of current management strategies. The risk of hepatic and extrahepatic malignancy was significantly increased in AIH and PSC patients.     

Enzyme- and immuno-histochemical study of childhood non-Hodgkin's lymphomas

Enzyme-and immuno-histochemical methods were applied to 19 childhood non-Hodgkin's lymphomas. According to the LSG classification, all lymphomas were of the diffuse type and comprised of 4 cases of the medium-sized cell type, 1 the mixed cell type, 3 the large cell type, 3 the Burkitt type and 8 the lymphoblastic type. Immunoperoxidase stains for the leukocyte common antigen on paraffin sections were positive in all 19 lymphomas while they were negative in all 6 childhood solid tumors. Surface and/or cytoplasmic immunoglobulin restricted to one light chain was demonstrated in 1 medium cell type and 3 Burkitt type lymphomas. Prolonged incubation of paraffin sections produced positive paranuclear ACP and ANAE reactions in 1 medium-sized cell type, 2 large cell and 4 lymphoblastic type lymphomas. Immunoperoxidase stains using monoclonal antibodies on fresh tissue imprints and frozen sections revealed appropriate surface markers for phenotyping individual lymphomas studied. In conclusion, the application of enzyme-and immuno-histochemical techniques helped to establish the diagnosis with a biologically meaningful subclassification of non-Hodgkin's lymphomas in children.     

Anthropometric factors and risk of myeloid leukaemias and myelodysplastic syndromes: a prospective study and meta-analysis

There is insufficient evidence linking excess body weight to risk of myeloid malignancies. We investigated this association using data from the Cancer Prevention Study-II (CPS-II), and a meta-analysis of published cohort studies. Among 152 090 CPS-II participants, 387 acute myeloid leukaemias (AML), 100 chronic myeloid leukaemias (CML) and 170 MDS were identified over 21 years of follow-up. In CPS-II, body mass index (BMI) was weakly associated with risk of CML (hazard ratio [HR] = 1·04, 95% confidence interval [CI]: 0·99–1·09 per 1 unit increase in BMI), AML (HR = 1·01, 95% CI: 0·98–1·03) and MDS (HR = 1·03, 95% CI: 0·99–1·07). After controlling for other anthropometric factors, no clear association was observed for height, BMI at age 18 years or weight change. In the meta-analysis (n = 7117 myeloid leukaemias), BMI 25–29·9 kg/m² (HR_pooled = 1·36, 95% CI: 1·12–1·59) and BMI ≥30 kg/m² (HR_pooled = 1·43, 95% CI: 1·18–1·69) were associated with higher risk of myeloid leukaemia overall, compared to a BMI <25 kg/m². Likewise, BMI ≥25 kg/m² was positively associated with both AML and CML risk individually in the meta-analysis. These results underscore the need for large studies to detect associations with rare cancers, and show a modest, but positive association between excess body weight and myeloid malignancy risk.     

Sport practice and the risk of lone atrial fibrillation: a case-control study

BACKGROUND: Lone atrial fibrillation (LAF) is characterized by the presence of atrial fibrillation in the absence of structural heart disease or other identifiable cause of arrhythmia. In a recent study, we reported sport practice to be more frequent in LAF patients than in the general population. The aim of the study was to determine the association between sport practice and the prevalence of LAF in men. METHODS: An age-matched case-control study was designed. Cases were identified from consecutive patients who attended an outpatient clinic; 51 men with LAF were included, 20 of them with vagal characteristics. Controls were selected from the general population (n=109). A questionnaire to assess former and current sport practice and the number of lifetime hours of sport practice was administered. Conditional logistic regression was used for statistical analysis. RESULTS: The proportion of patients with LAF who reported current sport practice (31%) was higher than that observed in controls (14%). In the logistic regression, current practice of sport was associated with a higher prevalence of LAF (OR=3.13; 95% CI: 1.39-7.05). The practice of more than 1500 lifetime hours of sport appears to be the threshold for the observed association. Current practice of sport with a lifetime practice greater than 1500 h was associated with LAF (OR=2.87; 95% CI: 1.20-6.91). CONCLUSION: In men, the combination of current and prolonged lifetime sport practice is associated with higher risk of LAF.     

SEN virus infection and the risk of hepatocellular carcinoma: a case-control study

OBJECTIVE: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major risk factors for hepatocellular carcinoma (HCC). The role of a novel DNA virus, designated SEN virus (SENV), in the etiology of liver cancer remains to be established. The aim of this study was to evaluate the association between SENV infection and the risk of HCC by conducting a hospital-based, case-control study among Thai patients. METHODS: Eighty-six patients with HCC were enrolled and matched individually to a control according to sex, age (+/- 5 yr), and geographic background. The presences of HBV DNA, HCV RNA, and SENV DNA in stored serum samples were detected with the use of semi-nested polymerase chain reaction amplification. RESULTS: Individuals who were infected with SENV did not have increased risk of developing HCC (OR=1.49, 95% CI=0.50-4.42). In contrast, those who were positive for HBV markers (hepatitis B surface antigen and/or HBV DNA) or HCV markers (anti-HCV and/or HCV RNA) had significant risk for HCC (OR=19.91, 95% CI=8.26-47.98 and OR=7.97, 95% CI=2.15-29.54, respectively). Moreover, coinfection with SENV did not further increase the risk of HCC among patients infected with HBV and/or HCV. CONCLUSION: Our data suggest that, unlike chronic HBV or HCV infection, SENV infection is not a risk factor for developing HCC in Thai populations.     

Statin use and the risk of colorectal cancer: a population-based case-control study

AIM: To investigate whether the use of statins is associated with colorectal cancer risk. METHODS: We conducted a population-based case-control study in Taiwan. Data were retrospectively collected from the Taiwan National Health Insurance Research Database. Cases consisted of all patients who were aged 50 years and older and had a first-time diagnosis of colorectal cancer between the period 2005 and 2008. The controls were matched to cases by age, sex, and index date. Adjusted odds ratios (ORs) and 95% conf...     

A case-control study of childhood environmental risk factors for the development of inflammatory bowel disease

OBJECTIVE : To clarify the relationship between childhood environment and the risk of subsequent development of Crohn's disease or ulcerative colitis. DESIGN AND OUTCOME MEASURES : A case-control study, assessing the risk of inflammatory bowel disease in relation to a series of historical and serological markers of childhood circumstance, analysed using the maximum likelihood form of conditional logistic regression. SETTING : District general hospital (secondary care institution). PARTICIPANTS : Subjects with Crohn's disease (n = 139) or ulcerative colitis (n = 137) aged between 16 and 45 years, each matched for sex and age with an outpatient control. RESULTS : Helicobacter seroprevalence was substantially reduced in Crohn's disease (OR 0.18; 95% CI, 0.06-0.52) but not in ulcerative colitis (OR 0.91; 95% CI, 0.38-2.16). In ulcerative colitis, a strong negative association with childhood appendectomy was confirmed (OR 0.05; 95% CI, 0.01-0.51). Crohn's disease was associated with childhood eczema (OR 2.81; 95% CI, 1.23-6.42) and the frequent use of a swimming pool (OR 2.90; 95% CI 1.21-6.91). There was no association between hepatitis A seroprevalence and either disease. CONCLUSION : The findings are consistent with the hypothesis that improved childhood living conditions are associated with increased risk of Crohn's disease. The study confirms that the negative association between appendectomy and ulcerative colitis relates primarily to events in childhood. Overall, the findings strongly support the assertion that childhood environment is an important determinant of the risk of inflammatory bowel disease in later life, with quite distinct risk factors for ulcerative colitis and Crohn's disease.     

Sociodemographic characteristics,risk factors and reproductive history in subjects with fibromyalgia--results of a population-based case-control study

Zusammenfassung. Ziel: Nach jüngeren Sch?tzungen leiden in westlichen Industrienationen 1,3–4,8% der Bev?lkerung an einer Fibromyalgie. 80–90% der Betroffenen sind Frauen. Dieses deutliche überwiegen von Frauen, zumeist im reproduktionsf?higen Alter, l?sst an einen Zusammenhang zwischen Fibromyalgie und Sexualhormonen denken. Methoden: Im Rahmen einer zweistufigen, bev?lkerungsbezogenen Querschnittstudie bei 3174 Frauen zwischen 35 und 74 Jahren in Bad S?ckingen wurde eine stratifizierte Zufallsstichprobe klinisch untersucht und befragt (n=653). Von diesen Frauen erfüllten 36 alle Kriterien einer Fibromyalgie. 44 Frauen litten unter chronischen, ausgebreiteten Schmerzen, aber keiner Fibromyalgie (chronische Schmerzprobanden), 408 Frauen hatten keine chronischen, ausgebreiteten Schmerzen (Kontrollen). Ergebnisse: Fibromyalgie-Probanden haben gegenüber Kontrollen das 3,6fache, und gegenüber chronischen Schmerzprobanden das 3,9fache Risiko, einem niedrigeren sozialen Status anzugeh?ren. Fibromyalgie-Probanden trinken sowohl im Vergleich zu Kontrollen als auch chronischen Schmerzprobanden seltener Alkohol. Von den in der gyn?kologischen Anamnese erhobenen Daten zeigte sich in multivariaten Analysen, dass nach Adjustierung für Alter die Fibromyalgie-Probanden gegenüber Kontrollen eine signifikant sp?tere Menarche hatten (OR=2,2 für >14 Jahre) und nie schwanger waren (OR=0,3). Beim Vergleich chronischer Schmerzprobanden mit den Kontrollen zeigten sich diese Assoziationen nicht. Folgerungen: Die bei den Fibromyalgie-Probanden gefundenen Zusammenh?nge mit niedrigem Sozialstatus, niedrigem Alkoholkonsum, sp?tem Menarchenalter und seltenen Schwangerschaften sind spezifisch für Fibromyalgie. Dies unterscheidet die Fibromyalgie-Probanden sowohl von den Kontrollen als auch den chronischen Schmerzprobanden. Die gleichen hormonellen Faktoren, die zu einer verz?gerten Menarche und einer verminderten Fertilit?t führen, scheinen bei der Entwicklung einer Fibromyalgie relevant zu sein. Correspondence to Thomas Schochat