Cigarette smoking increases the risk of nasopharyngeal carcinoma through the elevated level of IgA antibody against Epstein-Barr virus capsid antigen: A mediation analysis
Cigarette smoking increases the risk of nasopharyngeal carcinoma through the elevated level of IgA antibody against Epstein-Barr virus capsid antigen: A mediation analysis
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DOI：
10.1002/cam4.2832
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发表时间：
2020-03-01
期刊：
影响因子：
4
通讯作者：
Chen, Chien-Jen
中科院分区：
文献类型：
--
作者：
Hsu, Wan-Lun;Chien, Yin-Chu;Chen, Chien-Jen
研究目的：探讨吸烟与鼻咽癌（NPC）发病风险的关系，以及吸烟对EB病毒（EBV）感染的影响。方法：2010 - 2014年，在6家合作医院共收集1235例男性NPC病例和1262例与病例匹配的男性对照。使用标准化的问卷调查，吸烟和其他潜在的鼻咽癌危险因素的信息。收集血液并使用标准方法用于抗EBV VCA伊加和抗EBV EA-EBNA 1伊加测试。结果63.6%的病例组和44.0%的对照组有吸烟史，吸烟史与吸烟史的相关性为95%可信区间。完全校正后，与从不吸烟者相比，当前吸烟者的NPC风险显著增加1.60倍（95%CI = 1.30-1.97），既往吸烟者的NPC风险显著增加1.27倍（95%CI = 1.00-1.60）。鼻咽癌的风险增加的持续时间，强度和包年的吸烟，但不与吸烟开始的年龄。在对照组中，目前吸烟者的抗-EBV VCA伊加血清阳性率高于从不吸烟者（14.0% vs 8.4%; OR = 1.82; 95%CI = 1.19-2.79）。中介分析表明，超过90%的吸烟对鼻咽癌风险的影响是通过介导的抗EBV VCA伊加。结论本研究证实了长期吸烟与鼻咽癌之间的关联，并表明，目前吸烟与血清中抗EBV VCA伊加抗体阳性。
Background The study aims are to evaluate the associations between nasopharyngeal carcinoma (NPC) risk and cigarette smoking and to explore the effects of cigarette smoking on Epstein-Barr virus (EBV) infection for NPC risk.Methods 1235 male NPC cases and 1262 hospital-based male controls matched to cases were recruited across six collaborative hospitals between 2010 and 2014. Using a standardized questionnaire, information on cigarette smoking and other potential risk factors for NPC was obtained. Blood was collected and used for anti-EBV VCA IgA and anti-EBV EA-EBNA1 IgA testing using standard methods. Unconditional logistic regression analysis was used to estimate odds ratio (OR) with 95% confidence interval (CI) for each risk factor after adjusting for confounders.Results 63.6% of cases and 44.0% of controls reported ever smoking cigarettes. After full adjustment, current smokers had a significant 1.60-fold (95% CI = 1.30-1.97) and former smokers a borderline significant 1.27-fold (95% CI = 1.00-1.60) increased NPC risk compared to never smokers. NPC risk increased with increasing duration, intensity, and pack-years of cigarette smoking but not with age at smoking initiation. Among controls, anti-EBV VCA IgA seropositivity rate was higher in current smokers than never smokers (14.0% vs 8.4%; OR = 1.82; 95% CI = 1.19-2.79). Mediation analyses showed that more than 90% of the cigarette smoking effect on NPC risk is mediated through anti-EBV VCA IgA.Conclusion This study confirms the association between long-term cigarette smoking and NPC and demonstrates that current smoking is associated with seropositivity of anti-EBV VCA IgA antibodies.