Case-control study of non-Hodgkin's lymphoma among women and heterosexual men in the San Francisco Bay Area, California
Case-control study of non-Hodgkin's lymphoma among women and heterosexual men in the San Francisco Bay Area, California
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DOI：
10.1093/oxfordjournals.aje.a010017
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发表时间：
1999-08-15
影响因子：
5
通讯作者：
McGrath, MS
中科院分区：
文献类型：
--
作者：
Holly, EA;Lele, C;McGrath, MS
1988年至1995年在加州州弗朗西斯科湾区进行了一项以人群为基础的病例对照研究，以确定非霍奇金淋巴瘤的危险因素。参与者完成了面对面的采访，并抽取血液进行病毒和淋巴细胞亚群测试。本报告包括1，281例病例和2，095例对照的数据。在多变量分析中，与非霍奇金淋巴瘤风险降低相关的因素是对植物过敏，蜜蜂和黄蜂叮咬，五次或五次以上疫苗接种，降低血胆固醇的药物，非甾体抗炎药，性伴侣总数和终身使用大麻，而风险增加与西咪替丁和其他组胺H-2受体拮抗剂，脾切除术，淋病，和身体质量指数性别特异性模型的独特之处在于，女性患内分泌腺疾病的风险增加，男性患脊髓灰质炎的风险增加。非霍奇金淋巴瘤患者的中位CD 3、CD 4、CD 8、CD 20和淋巴细胞计数显著低于对照组。这些结果暗示环境因素可能通过刺激免疫系统影响淋巴瘤发生的早期阶段。积累形成淋巴瘤的抗原驱动的B细胞可能会受到免疫应激的抑制，例如暴露于更多的性伴侣和某些药物。过敏史为B细胞分化的持续能力提供了证据，因此B细胞的积累减少。使用非甾体类抗炎药和降胆固醇药物降低非霍奇金淋巴瘤的风险与巨噬细胞在B细胞增殖中的炎症作用一致。
A population-based case-control study was conducted between 1988 and 1995 in the San Francisco Bay Area of California to determine risk factors for non-Hodgkin's lymphoma. Participants completed in-person interviews, and blood was drawn to test for viruses and lymphocyte subsets. This report includes data for 1,281 cases and 2,095 controls. In multivariate analyses, the factors associated with a decreased risk for non-Hodgkin's lymphoma were allergy to plants, bee and wasp stings, five or more vaccinations, drugs to lower blood cholesterol, nonsteroidal anti-inflammatory drugs, total number of sexual partners, and lifetime marijuana use, whereas an increased risk was associated with cimetidine and other histamine H-2-receptor antagonists, splenectomy, gonorrhea, and body mass index. Unique to sex-specific models was an increased risk for endocrine gland disorders among women and for polio among men. Median CD3, CD4, CD8, CD20, and lymphocyte counts for non-Hodgkin's lymphoma patients were significantly lower than those for controls. These results implicate environmental factors that may influence the early stages of lymphomagenesis by stimulating the immune system. Antigen-driven B cells that accumulate to form lymphoma may be suppressed by immunologic stresses such as exposure to an increased number of sexual partners and to certain medications. A history of allergies provides evidence for a persistent capacity for B-cell differentiation and therefore a decreased accumulation of B cells. The decreased risk for non-Hodgkin's lymphoma with use of nonsteroidal anti-inflammatory drugs and cholesterol-lowering drugs is consistent with a macrophage inflammatory role in B-cell proliferation.