A nested case-control study on risk factors for development of adult T-cell leukemia/lymphoma among HTLV-I carriers

HTLV-I 携带者发生成人 T 细胞白血病/淋巴瘤危险因素的巢式病例对照研究

• 批准号: 09670398
• 负责人: ARISAWA Kokichi
• 金额: $ 2.3万
• 依托单位: Nagasaki University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1999
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09670398/
• 关键词: adult T-cell leukemia; lymphoma; Cohort study; HTLV-I antibody; HTLV-I infection; Incidence; Liver neoplasms; Mortality; non-Hodgkin's lymphoma; Risk factor; 罹患率; リスクファクター; 非ホジキンリンパ腫; 発症率; 寄与割合; T-細胞; 肝がん; 慢性肝疾患

There have been few longitudinal studies on the long-term health effects of human T-lymphotropic virus type-I (HTLV-I) infection. The authors performed a cohort study of HTLV-I infection and cause-specific mortality in 3,090 atomic-bomb survivors in Nagasaki, Japan, who were followed from 1985-1987 to 1995. The prevalence of HTLV-I seropositivity in men and women was 99/1,196 (8.3%) and 171/1,894 (9.0%), respectively. During a median follow-up of 8.9 years, 448 deaths occurred. There was one nonfatal case of adult T-cell leukemia/lymphoma (incidence rate=0.46 cases/ 1,000 person-years; 95% confidence interval [CI] 0.01-2.6). After adjustment for sex, age and other potential confounders, significantly increased risk among HTLV-I carriers was observed for deaths from all causes (rate ratio [RR]=1.41), all cancers (RR=1.64), liver cancer (RR=3.04), and heart diseases (RR=2.22). The association of anti-HTLV-I seropositivity with mortality from all non-neoplastic diseases (RR= 1.40) and chr … More onic liver diseases (RR=5.03 ) was of borderline significance. Possible confounding by blood transfusions and hepatitis C/B (HCV/HBV) viral infections could not be precluded in this study. However, even after liver cancer and chronic liver diseases were excluded, mortality rate was still increased among HTLV-I carriers (RR=1.32, 95% CI 0.99-1.78), especially among those with high antibody titers (RR=1.56, 95% CI 0.99-2.46, P for trend=0.04). These findings may support the idea that HTLV-I infection exerts adverse effects on mortality from causes other than adult T-cell leukemia/lymphoma. Further studies on confounding by HCV/HBV infections and the interaction between HCV/HBV and HTLV-I may be required to analyze the increased mortality from liver cancer and chronic liver diseases.(2) Evaluation of adult T-cell Leukemia/lymphoma incidence and its impact on non-Hodgkin's lymphoma incidence in southwestern JapanThe incidence of adult T-cell leukemia/lymphoma (ATL) and its impact on that of total non-Hodgkin lymphoma (NHL) were evaluated in Nagasaki, a human T-cell lymphotropic virus type-I (HTLV-I) endemic area in southwestern Japan. The first study area consisted of four towns located on the K-Islands, which had a population of 26,870 in 1990. The overall HTLV-I seroprevalence estimated from the serologic survey of 18,485 subjects was 16.2%. By using the data from the Nagasaki Prefectural Cancer Registry (NPCR) and reviewing clinical and laboratory information, the authors identified 40 cases of ATL and 35 cases of other NHL diagnosed during 1985-1995. The crude annual incidence of ATL among 100,000 HTLV-I carriers aged 30 or older was estimated at 137.7 for men and 57.4 for women, with a significant sex difference after adjustment for age (rate ratio=2.50, 95% confidence interval 1.32-4.73 ). The cumulative risk from 30 to 79 years of age was estimated at approximately 6.6% for men and 2.1% for women. Among the entire population, ATL accounted for 51-59% of the total NHL incidence, showing the strong impact of HTLV-I infection. The second study area consisted of the whole of Nagasaki Prefecture (total population in 1990=1.56 million). Between 1985 and 1995, 989 cases of ATL and 1,745 cases of other NHL were registered in the NPCR. The world age-standardized annual incidence rate of ATL per 100,000 persons aged 30 or older was estimated at 10.5 for men and 6.0 for women, which accounted for approximately 37-41% of the total NHL incidence. Less

关于人T-淋巴细胞性病毒I型（HTLV-I）感染的长期健康影响的纵向研究很少。作者对日本纳加萨崎的3,090个原子炸弹表面进行了HTLV-1感染和特定原因的死亡率进行了一项队列研究，从1985- 1987年到1995年，他们随后均受到HTLV-1血统的盛行。在中位随访8。9年期间，发生了448例死亡。有一个成人T细胞白血病/淋巴瘤的非致命病例（发病率= 0.46病例/ 1,000人年； 95％置信区间[CI] 0.01-2.6）。调整性别，年龄和其他潜在的混杂因素后，所有原因（速率比）[RR] = 1.41）的死亡观察到HTLV-1携带者之间的风险显着增加，所有癌症（RR = 1.64），肝癌（RR = 3.04）和心脏疾病（RR = 2.22）（RR = 2.22）。抗HTLV-I血清阳性与所有非塑性疾病（RR = 1.40）和CHR…更多的肝病（RR = 5.03）的死亡率均具有边缘意义。在这项研究中，无法通过输血和丙型肝炎（HCV/HBV）病毒感染的混淆。然而，即使排除了肝癌和慢性肝病，HTLV-1载体中的死亡率仍会增加（RR = 1.32，95％CI 0.99-1.78），尤其是在较高抗体滴度的人群中（RR = 1.56，95％CI 0.99-2.46，P for thrat = 0.04）。这些发现可能支持HTLV-I感染对成人T细胞白血病/淋巴瘤以外的其他原因产生不利影响的想法。可能需要关于HCV/HBV感染混淆以及HCV/HBV和HTLV-I之间的相互作用的进一步研究，以分析肝癌和慢性肝病的死亡率增加。（2）评估成人T-cell白血病/淋巴瘤的成人淋巴瘤及其对非Hodgkin的淋巴瘤的影响及其对南部淋巴瘤的影响。 （ATL）及其对总非霍奇金淋巴瘤（NHL）的影响在日本西南部的人类T细胞淋巴细胞型I型（HTLV-I）内人体区域进行了评估。第一个研究区域是位于K-兰兹群岛的四个城镇一致的，该城镇在1990年人口为26,870。从18,485名受试者的血清学调查中估计的HTLV-I血清阳性率为16.2％。通过使用长崎县癌登记处（NPCR）的数据并审查临床和实验室信息，作者在1985 - 1995年期间确定了40例ATL和35例其他NHL诊断病例。在100,000名HTLV-I载体中，ATL年度为30岁或30岁以上的ATL年度发病率估计为男性为137.7，女性为57.4，年龄调整后的性别差异很大（速率比= 2.50，95％置信区间1.32-4.73）。估计男性的30至79岁风险估计约为6.6％，女性为2.1％。在整个人群中，ATL占NHL总事件的51-59％，显示了HTLV-1感染的强烈影响。第二个研究领域包括整个长崎县（1990年的总人口= 156万）。在1985年至1995年之间，在NPCR中注册了989例ATL和1,745例其他NHL病例。世界年龄标准化的年龄为30岁或30岁以上的人为10.5的年龄为每100,000人的年龄为10.5，女性为6.0，约占NHL总发病率的37-41％。较少的

项目成果

Arisawa K, Soda M, Akahoshi M, Nakashima E, Matsuo T, Tomonaga M, Saito H: "Human T-lymphotropic virus type-I infection, antibody titers and cause-specific mortality among atomic-bomb survivors"Jpn J Cancer Res. 89(8). 797-805 (1998)

Arisawa K、Soda M、Akahoshi M、Nakashima E、Matsuo T、Tomonaga M、Saito H：“原子弹幸存者中的人类 T 淋巴细胞病毒 I 型感染、抗体滴度和特定原因死亡率”Jpn J Cancer Res。

有澤孝吉: "公衆衛生学第3版"講談社. 165 (999)

有泽浩吉：《公共卫生第3版》讲谈社165（999）。

有澤孝吉: "公衆衛生学第3版"講談社. 165 (1997)

有泽浩吉：《公共卫生第 3 版》讲谈社 165 (1997)。

Arisawa,K: "Evaluation of acult T-sell leukemia/lymphoma incrdence and its impact on non-Hodgkin's lymphamaincidence in southern Japan"Int.J.Cancer. 85(3). 319-324 (2000)

Arisawa,K：“日本南部急性 T 型白血病/淋巴瘤发病率的评估及其对非霍奇金淋巴瘤发病率的影响”Int.J.Cancer。

Arisawa, K: "Human T-lymphotropic virus type-I infection, antibody titers and cause-specific mertality among atomic bomb survivors"Jpn. J. Cancer Res.. 89(8). 797-805 (1998)

Arisawa, K：“原子弹幸存者中人类 T 淋巴细胞病毒 I 型感染、抗体滴度和特定原因死亡”Jpn。