Perinatal and Familial Risk Factors for Brain Tumors in Childhood through Young Adulthood
Perinatal and Familial Risk Factors for Brain Tumors in Childhood through Young Adulthood
复制标题
DOI：
10.1158/0008-5472.can-14-2285
复制
发表时间：
2015-02-01
期刊：
影响因子：
11.2
通讯作者：
Sundquist, Kristina
中科院分区：
文献类型：
--
作者：
Crump, Casey;Sundquist, Jan;Sundquist, Kristina
在病例对照研究中，围产期因素，包括高出生体重，与儿童脑肿瘤有关。然而，胎龄和胎儿生长的具体贡献仍然未知，这些问题从未在成年期随访的大型队列研究中进行过检查。我们对1973-2008年在瑞典出生的3,571,574人进行了一项全国性队列研究，随访脑肿瘤发病率至2010年（最大年龄38岁），以检查围产期和家族危险因素。在6970万人-年的随访中发现2809例脑肿瘤。在对潜在混杂因素进行调整后，脑肿瘤的重要危险因素包括胎儿生长高[每增加1个SD的发病率比（IRR）为1.04；95%可信区间（CI）， 1.01-1.08, P = 0.02)，一级脑肿瘤家族史（IRR, 2.43; 95% CI, 1.86-3.18, P < 0.001），父母出生国（瑞典出生的父母与其他国家出生的父母的IRR， 1.21; 95% CI, 1.09-1.35, P < 0.001），以及母亲高教育水平（P趋势= 0.01）。这些危险因素在诊断时没有随年龄变化。与高胎儿生长相关的似乎包括毛细胞星形细胞瘤，但不包括其他星形细胞瘤、髓母细胞瘤或室管膜瘤。出生胎龄、出生顺序、多胎和父母年龄与脑肿瘤无关。在这项大型队列研究中，高胎儿生长与脑肿瘤（特别是毛细胞星形细胞瘤）的风险增加相关，与胎龄无关，不仅在儿童期，而且在青年期，这表明生长因子途径可能在某些脑肿瘤亚型的病因学中起重要的长期作用。(c) 2014年aacr。
Perinatal factors, including high birth weight, have been associated with childhood brain tumors in case-control studies. However, the specific contributions of gestational age and fetal growth remain unknown, and these issues have never been examined in large cohort studies with follow-up into adulthood. We conducted a national cohort study of 3,571,574 persons born in Sweden in 1973-2008, followed up for brain tumor incidence through 2010 (maximum age 38 years) to examine perinatal and familial risk factors. There were 2,809 brain tumors in 69.7 million person-years of follow-up. After adjusting for potential confounders, significant risk factors for brain tumors included high fetal growth [incidence rate ratio (IRR) per additional 1 SD, 1.04; 95% confidence interval (CI), 1.01-1.08, P = 0.02], first-degree family history of a brain tumor (IRR, 2.43; 95% CI, 1.86-3.18, P < 0.001), parental country of birth (IRR for both parents born in Sweden vs. other countries, 1.21; 95% CI, 1.09-1.35, P < 0.001), and high maternal education level (P-trend = 0.01). These risk factors did not vary by age at diagnosis. The association with high fetal growth appeared to involve pilocytic astrocytomas, but not other astrocytomas, medulloblastomas, or ependymomas. Gestational age at birth, birth order, multiple birth, and parental age were not associated with brain tumors. In this large cohort study, high fetal growth was associated with an increased risk of brain tumors (particularly pilocytic astrocytomas) independently of gestational age, not only in childhood but also into young adulthood, suggesting that growth factor pathways may play an important long-term role in the etiology of certain brain tumor subtypes. (C) 2014 AACR.