Fetal Growth and Childhood Cancer: A Population-Based Study
Fetal Growth and Childhood Cancer: A Population-Based Study
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DOI：
10.1542/peds.2013-1317
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发表时间：
2013-11-01
期刊：
影响因子：
8
通讯作者：
Troisi, Rebecca
中科院分区：
文献类型：
--
作者：
Bjorge, Tone;Sorensen, Henrik Toft;Troisi, Rebecca
目的：儿童癌症的病因在很大程度上尚不清楚。研究表明出生特征可能与风险相关。我们的目标是评估与胎儿生长相关的儿童癌症风险。方法：我们在北欧出生登记处进行了一项病例对照研究。该研究纳入了丹麦、芬兰、挪威和瑞典 1967 年至 2010 年出生的儿童中诊断出的癌症病例，每个病例最多有 10 个匹配对照，总计 17 698 例病例和 172 422 名对照。比值比 (OR) 和 95% 置信区间 (95% CI) 来自条件逻辑回归。 结果：所有儿童癌症的风险随着出生体重的增加而增加（P 趋势为 4000 g，出生体重 >4500 g 时中枢神经系统肿瘤的风险增加。大于胎龄的新生儿患肾母细胞瘤的风险增加（OR：2.1 [95% CI：1.2-3.6]）和结缔组织/软组织肿瘤（OR：2.1 [95% CI：1.1-4.4]）相比之下，小于胎龄的儿童患急性髓性白血病的风险增加（OR：1.8 [95% CI：1.1-3.1]）。1 岁时诊断出患有中枢神经系统肿瘤的儿童的风险随着头围的增加而增加（P 趋势 < .001）。 >39 厘米的风险最高（OR：4.7 [95% CI：2.5-8.7]）。结论：在这项基于北欧人群的大型研究中，多种儿童肿瘤风险的增加与胎儿生长的测量相关，这支持了儿童期肿瘤发生在子宫内开始的假设。
OBJECTIVE: The etiology of childhood cancers is largely unknown. Studies have suggested that birth characteristics may be associated with risk. Our goal was to evaluate the risk of childhood cancers in relation to fetal growth.METHODS: We conducted a case-control study nested within Nordic birth registries. The study included cancer cases diagnosed in Denmark, Finland, Norway, and Sweden among children born from 1967 to 2010 and up to 10 matched controls per case, totaling 17 698 cases and 172 422 controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were derived from conditional logistic regression.RESULTS: Risks of all childhood cancers increased with increasing birth weight (P-trend 4000 g and of central nervous system tumors when birth weight was >4500 g. Newborns large for gestational age were at increased risk of Wilms tumor (OR: 2.1 [95% CI: 1.2-3.6]) and connective/soft tissue tumors (OR: 2.1 [95% CI: 1.1-4.4]). In contrast, the risk of acute myeloid leukemia was increased among children born small for gestational age (OR: 1.8 [95% CI: 1.1-3.1]). Children diagnosed with central nervous system tumors at,1 year of age had elevated risk with increasing head circumference (P-trend < .001). Those with head circumference >39 cm had the highest risk (OR: 4.7 [95% CI: 2.5-8.7]).CONCLUSIONS: In this large, Nordic population-based study, increased risks for several childhood tumors were associated with measures of fetal growth, supporting the hypothesis that tumorigenesis manifesting in childhood is initiated in utero.