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

基本信息

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

项目摘要

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

关于人类 T 淋巴细胞病毒 I 型 (HTLV-I) 感染的长期健康影响的纵向研究很少。作者对 3,090 个原子弹中的 HTLV-I 感染和特定原因死亡率进行了队列研究。日本长崎的幸存者从 1985 年至 1987 年至 1995 年进行了跟踪调查。男性和女性中 HTLV-I 血清阳性的患病率分别为 99/1,196 (8.3%) 和 171/1,894 (9.0%) 在中位随访 8.9 年期间，发生 448 例成人 T 细胞白血病/淋巴瘤非致命病例（发病率为 0.46）。例/1,000 人年；95% 置信区间 [CI] 0.01-2.6）。调整性别、年龄和其他潜在混杂因素后，观察到 HTLV-I 携带者因各种原因死亡（比率 [RR]=1.41）、所有癌症（RR=1.64）、肝癌（RR=3.04）的风险显着增加和心脏病 (RR=2.22) 抗 HTLV-I 血清阳性与所有非肿瘤性疾病死亡率的关联 (RR=1.40) 和 chr … 更多然而，即使排除了肝癌和慢性肝病，本研究也不能排除输血和乙型肝炎（HCV/HBV）病毒感染可能造成的混淆。 HTLV-I 携带者的死亡率仍然升高（RR=1.32，95% CI 0.99-1.78），尤其是抗体滴度高的携带者（RR=1.56，95% CI 0.99-2.46，趋势 P=0.04）这些发现可能支持 HTLV-I 感染对成人 T 细胞白血病/淋巴瘤以外的原因造成的死亡率产生不利影响的观点。分析肝癌和慢性肝病死亡率的增加可能需要HCV/HBV感染的混杂以及HCV/HBV与HTLV-I之间的相互作用。(2)评估日本西南部成人 T 细胞白血病/淋巴瘤发病率及其对非霍奇金淋巴瘤发病率的影响在长崎评估了成人 T 细胞白血病/淋巴瘤 (ATL) 的发病率及其对总非霍奇金淋巴瘤 (NHL) 发病率的影响日本西南部人类 T 细胞淋巴细胞病毒 I 型 (HTLV-I) 流行区第一个研究区域由位于 K 群岛的四个城镇组成。 1990 年，该地区人口为 26,870 人。根据对 18,485 名受试者的血清学调查估计，HTLV-I 血清总体患病率为 16.2%。通过使用长崎县癌症登记处 (NPCR) 的数据并审查临床和实验室信息，作者确定。 1985-1995 年间诊断的 40 例 ATL 和 35 例其他 NHL 的粗年发病率。 100,000 名 30 岁或以上的 HTLV-I 携带者中，男性 ATL 估计为 137.7，女性为 57.4，调整年龄后存在显着的性别差异（比率 = 2.50，95% 置信区间 1.32-4.73）。 30岁至79岁的人群中，男性约占6.6%，女性约占2.1%。人口中，ATL 占 NHL 总发病率的 51-59%，显示 HTLV-I 感染的强烈影响。第二个研究区域包括整个长崎县（1990 年总人口 = 1985 年至 1995 年）。 NPCR 中登记了 989 例 ATL 病例和 1,745 例其他 NHL 病例。 10万名30岁以上的人估计男性为10.5，女性为6.0，约占NHL总发病率的37-41%。