The two-stage clonal expansion model in occupational cancer epidemiology: results from three cohort studies.
The two-stage clonal expansion model in occupational cancer epidemiology: results from three cohort studies.
复制标题
职业癌症流行病学中的两阶段克隆扩张模型：三项队列研究的结果。
DOI：
10.1136/oem.2009.053983
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发表时间：
2011
影响因子：
4.9
通讯作者：
Kriebel,David
中科院分区：
文献类型：
--
作者：
Zeka,Ariana;Gore,Rebecca;Kriebel,David
本研究的目的是应用两阶段克隆扩展模型，以扩展该模型的流行病学应用文献，并论证将基于生物学的建模方法结合到广泛使用的回溯性队列研究中的可行性。方法作者将两阶段克隆扩展模型应用于三项职业队列研究：(1)接触石棉的纺织工人队列，跟踪调查肺癌死亡率；(2)接触二氧化硅的硅藻土工队列，跟踪肺癌死亡率；(3)暴露于直金属加工液(MWF)的汽车制造工人队列，跟踪喉癌发病率。该模型允许作者在三个阶段估计暴露效应：癌症起始(早期效应)、促进或恶变(晚期效应)。结果在第一个队列中，作者发现了石棉对肺癌风险早期影响的有力证据。对第二个队列的分析结果表明，二氧化硅对肺癌风险的早期和较不明显的晚期影响。在MWF(第三组)队列中，只有微弱的证据表明MWF暴露对早期和晚期都有直接影响。作者还观察到了晚产队列对喉癌风险的影响。结论石棉和二氧化硅的研究结果基本上是确凿的，支持了大量文献中关于它们对肺癌早期影响的证据。直射MWF对喉癌的疗效尚不清楚。
ObjectivesThe objective of this work was to apply the two-stage clonal expansion model, with the intention to expand the literature on epidemiological applications of the model and demonstrate the feasibility of incorporating biologically based modelling methods into the widely used retrospective cohort study.MethodsThe authors fitted the two-stage clonal expansion model model to three occupational cohort studies: (1) a cohort of textile workers exposed to asbestos and followed for lung cancer mortality; (2) a cohort of diatomaceous earth workers exposed to silica and also followed for lung cancer mortality; and (3) a cohort of automotive manufacturing workers exposed to straight metalworking fluid (MWF) and followed for larynx cancer incidence. The model allowed the authors to estimate exposure effects in three stages: cancer initiation (early effects), promotion or malignant transformation (late effects).ResultsIn the first cohort, the authors found strong evidence for an early effect of asbestos on lung cancer risk. Findings from analyses of the second cohort suggested early and less evidently late effects of silica on lung cancer risk. In the MWF (third) cohort, there was only weak evidence of straight MWF exposure effects on both early and late stages. The authors also observed a late birth cohort effect on larynx cancer risk.ConclusionsThe findings for asbestos and silica were essentially confirmatory, supporting evidence for their early effects on lung cancer from a large body of literature. The effect of straight MWF on larynx cancer was less clear.