EPIDEMIOLOGY OF EBV DEFINED HODGKINS DISEASE

描述：(改编自《调查者摘要》)这项研究将探索 霍奇金氏病(HD)亚型的流行病学 Epstein-Barr病毒(EBV)。最近在HD肿瘤中发现了EBV 将这种常见的病毒作为致病因素牵连到一半的病例。而当 实验室研究报告EBV阳性和EBV阳性之间有趣的差异 -高清阴性病例，这些数据稀少，缺乏技术 一致性和流行病学重点。因此，流行病学风险因素， 包括艾滋病毒和EBV定义的HD的发病率仍然很低 尽管HD肿瘤的EBV分类对 HD的病原学、监测和疫苗接种预防。这个 调查人员表示，这项研究将是第一次描述 EBV定义的HD在基于人群的病例系列中进行了统一测试 可靠的EBV分析，病理上重新审查，并且足够大，足以 HD复杂的流行病学要求进行详细的检查。本研究 目的：1)收集1990-1995年HD事件的存档肿瘤标本 向基于人口的加州癌症登记中心(CCR)报告的病例；2) 应用标准分子技术检测EB病毒潜伏基因产物 至于将每个病例归类为EBV阳性或阴性；3)计算 建议表征的变量的EBV阳性和阴性HD EBV定义的HD，并可在CCR数据库中获得(年龄、性别、种族、出生 地点、发病地点和阶段)或由本研究确定(重新审查 组织学亚型、基于连锁的艾滋病状态)；4)计算发病率 对于EBV阳性和阴性HD，标准化发病率为 确定艾滋病是否与HD有关；5)保存肿瘤标本以备将来使用 测试。调查人员将从几家大型公司获得案件清单 CCR区域，分层随机抽样，索取肿瘤标本 2543名受试者。他们将检测他们预计获得的2140份EBV EBER阳性和阴性基因产物的原位杂交 对照；并进行EBV染色和LMP-1测序以进一步 探索EBV阳性。他们将把数据库链接到研究区 以人口为基础的艾滋病登记处，以确定艾滋病状况。资料分析 将通过研究变量比较EBV阳性和阴性HD 描述性统计学.检验EBV假说的多变量分析 亚组之间的风险；以及发病率和标准化的计算 发病率。研究人员指出，这项研究的优势包括 及时探索与常见病毒(EBV)相关的HD风险 预防潜力；以人口为基础的病例系列足以 相关、详细的分析；统一应用最先进的技术 分子分析；现有癌症和艾滋病数据库的使用 分子数据；专家病理学重新审查；以及第一次检查 重新审查的以人群为基础的艾滋病相关HD和EBV病例。

DESCRIPTION: (Adapted from Investigator's Abstract) This study will explore the epidemiology of subtypes of Hodgkin's disease (HD) defined by Epstein-Barr virus (EBV). Recent identification of EBV in HD tumors has implicated this common virus as a causal cofactor to half the cases. While laboratory studies report intriguing differences between EBV-positive and -negative HD cases, these data are sparse, and they lack technical uniformity and epidemiologic focus. Thus, epidemiologic risk factors, including HIV and the incidence rate of EBV-defined HD, remain poorly defined, although EBV classification of HD tumors has significance for the etiology, surveillance, and prevention of HD through vaccination. The investigators state that this study will be the first to characterize EBV-defined HD in a population-based case series uniformly tested with reliable EBV assays, pathologically re-reviewed, and large enough for the detailed examination required by the complex epidemiology of HD. This study aims to: 1) collect archived tumor specimens from 1990-1995 incident HD cases reported to the population-based California Cancer Registry (CCR); 2) apply standard molecular techniques to test for EBV latent gene products so as to classify each case as EBV-positive or -negative; 3) calculate risks of EBV-positive and -negative HD for variables suggested to characterize EBV-defined HD and available in the CCR database (age, sex, race, birth place, disease site and stage) or determined by this study (re-reviewed histologic subtype, linkage-based AIDS status); 4) calculate incidence rates for EBV-positive and -negative HD, and standardized incidence ratios to determine if AIDS is associated with HD; 5) bank tumor specimens for future testing. The investigators will acquire case listings from several large CCR regions, select a stratified random sample, and request tumor specimens for 2,543 subjects. They will test the 2,140 they expect to obtain for EBV gene products using EBER in situ hybridization with positive and negative controls; and conduct EBV stain-typing and LMP-1 sequencing to further explore EBV positivity. They will link the database to study-area population-based AIDS registries to determine AIDS status. Data analysis will compare EBV-positive and -negative HD by study variables using descriptive statistics; multivariate analyses to test hypotheses about EBV risks among subgroups; and calculation of incidence rates and standardized incidence ratios. The investigators point out that study strengths include timely exploration of HD risks associated with a common virus (EBV) with prevention potential; a population-based case series large enough for relevant, detailed analysis; uniform application of state-of-the-art molecular assays; use of existing cancer and AIDS databases augmented by molecular data; expert pathology re-review; and the first examination of AIDS-linked HD and EBV in population-based, re-reviewed cases.