PO.PS01.06 · 人群科学

一项基于医院的多中心淋巴系统和髓系肿瘤病例对照研究（AsiaLymph）：关于教育程度、体质指数和家族史的研究设计与初步发现

A multi-center hospital-based case-control study of lymphoid and myeloid neoplasms (AsiaLymph): Study design and initial findings for education, body mass index, and family history

编号 5051 展板 24 时间 4/21 09:00–12:00 区域 Section 35 主讲 Qing Lan, MD;PhD

分会场 Diet, Alcohol, and Tobacco, and Other Lifestyle Factors

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作者与单位 Authors & Affiliations

Qing Lan¹, Lauren M. Hurwitz¹, John K. Chan², Tai Hing Lam³, Kexin Chen⁴, Yok Lam Kwong⁵, Xu Caigang⁶, Brian CH Chiu⁷, Raymond Liang⁸, Ip Dennis³, Wei Hu¹, Bryan Bassig⁹, Mark Purdue¹, Jun Xu³, Sarah Locke¹, Sophia S. Wang¹⁰, James R. Cerhan¹¹, Sonja Berndt¹, Jonathan N. Hofmann¹, Jianxin Shi¹, Kai Yu¹, Shahinaz Gadalla¹, Lisa J. McReynolds¹, Rena Jones¹, Hongji Dai⁴, Zhangyan Lyu⁴, Lugui Qiu¹², Wei Liu¹², Huilai Zhang¹³, Xianhuo Wang¹³, Lindsay M. Morton¹, Stephen Chanock¹, Martha Linet¹, Melissa C. Friesen¹, Roel Vermeulen¹⁴, Nathaniel Rothman¹

¹NCI Div. of Cancer Epidemiology & Genetics, Bethesda, MD,²Queen Elizabeth Hospital, Hong Kong, Hong Kong,³School of Public Health, Li Ka Shing (LKS) Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong,⁴Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China,⁵Queen Mary Hospital, Hong Kong, Hong Kong,⁶Department of Hematology, Hematology Research Laboratory, West China Hospital, Sichuan University, Chengdu, China,⁷Associate Professor, Dept. of Health Studies, University of Chicago, Chicago, IL,⁸Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong,⁹Saville Cancer Screening and Prevention Center, Inova Schar Cancer Institute, Inova Health System, Fairfax, VA,¹⁰City of Hope National Medical Center, Duarte, CA,¹¹Mayo Clinic College of Medicine and Science, Rochester, MN,¹²Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China,¹³Tianjin Medical University Cancer Institute and Hospital, Tianjin, China,¹⁴Utrecht University, Utrecht, Netherlands

摘要 Abstract

中文摘要

背景：流行病学及其他研究已确定了淋巴系统和髓系恶性肿瘤的环境、职业和遗传危险因素，但大多数研究是在西方人群中开展的。为全面理解造血系统肿瘤的病因，需要在暴露模式、疾病亚型分布和遗传结构各不相同的人群中开展研究。方法：我们在东亚开展了一项大型、多中心、基于医院的淋巴系统和髓系肿瘤病例对照研究（AsiaLymph），纳入5,671例淋巴系统肿瘤病例、1,879例髓系肿瘤病例和3,858例对照。参与者完成了计算机辅助个人访谈并提供了生物样本。病例经中心病理复审并按WHO分类进行编码。在此，我们详细描述研究方法，并报告教育程度、体质指数和家族史的关联结果。结果：20岁时较高的BMI（而非40岁时）与总淋巴系统肿瘤（每增加5 kg/m2：OR [95% CI]：1.18 [1.09-1.27]）、总髓系肿瘤（OR [95% CI]：1.17 [1.05-1.29]）以及若干亚型的患病风险相关。较高的受教育程度与总淋巴系统肿瘤患病风险升高相关（大学vs.低于小学教育：OR [95% CI]：1.41 [1.21-1.65]），但与髓系肿瘤无关（OR [95% CI]：1.17 [0.95-1.45]；异质性p=0.02）。一级亲属血液系统肿瘤家族史与淋巴系统肿瘤（OR [95% CI]：1.53 [1.15-2.03]）和髓系肿瘤（OR [95% CI]：1.65 [1.11-2.44]）以及特定亚型的患病风险也呈正相关。所评估的危险因素均与NK/T细胞淋巴瘤无关联，这支持该亚型具有独特的病因。结论：AsiaLymph研究是关于淋巴系统和髓系肿瘤、并采用标准化世界卫生组织组织病理学亚型分类的最大规模分子流行病学研究之一，将成为对这些恶性肿瘤危险因素进行病因学研究的宝贵资源。

查看英文原文 English abstract

Background: Epidemiologic and other studies have identified environmental, occupational, and genetic risk factors for lymphoid and myeloid malignancies, but most studies have been conducted in Western populations. Investigations in populations with differing exposure patterns, distributions of disease subtypes, and genetic architecture are needed to fully understand hematopoietic tumor etiology. Methods: We conducted a large, multicenter, hospital-based case-control study of lymphoid and myeloid neoplasms in East Asia (AsiaLymph), including 5,671 lymphoid cases, 1,879 myeloid cases, and 3,858 controls. Participants completed a computer-assisted personal interview and provided biospecimens. Cases underwent central pathology review and were coded into the WHO Classification. Herein, we describe the study methods in detail and report association results for education, body mass index, and family history. Results: Greater BMI at age 20 but not at age 40 was associated with odds of total lymphoid neoplasm (per 5 kg/m 2 increase: OR [95% CI]: 1.18 [1.09-1.27]), total myeloid neoplasm (OR [95% CI]: 1.17 [1.05-1.29]), and several subtypes. Greater educational attainment was associated with increased odds of total lymphoid neoplasm (for college vs. less than primary education: OR [95% CI]: 1.41 [1.21-1.65]) but not myeloid neoplasm (OR [95% CI]: 1.17 [0.95-1.45]; p-heterogeneity=0.02). There were also positive associations between family history of hematologic cancer in first degree relatives and odds of lymphoid neoplasm (OR [95% CI]: 1.53 [1.15-2.03]) and myeloid neoplasm (OR [95% CI]: 1.65 [1.11-2.44]) and specific subtypes. None of the evaluated risk factors were associated with NK/T-cell lymphoma, which supports a distinct etiology for this subtype. Conclusion: The AsiaLymph Study is one of the largest molecular epidemiology studies of both lymphoid and myeloid neoplasms with standardized World Health Organization classification of histopathologic subtypes and will serve as a valuable resource for etiologic investigations into risk factors for these malignancies.

利益披露 Disclosure

Q. Lan, None.. L. M. Hurwitz, None.. J. K. Chan, None.. T. Lam, None.. K. Chen, None.. Y. Kwong, None.. X. Caigang, None.. R. Liang, None.. I. Dennis, None.. W. Hu, None.. B. Bassig, None.. M. Purdue, None.. J. Xu, None.. S. Locke, None.. S. Berndt, None.. J. N. Hofmann, None.. J. Shi, None.. K. Yu, None.. S. Gadalla, None.. L. J. McReynolds, None.. R. Jones, None.. H. Dai, None.. Z. Lyu, None.. L. Qiu, None.. W. Liu, None.. H. Zhang, None.. X. Wang, None.. L. M. Morton, None.. S. Chanock, None.. M. Linet, None.. M. C. Friesen, None.. N. Rothman, None.

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