恶性淋巴瘤发病与病毒感染的配对病例-对照研究

A Paired Case-control Study for Assessing the Relationship Between the Incidence of Malignant Lymphomas and the Viruses Infections

目的 评价四川地区病毒感染与恶性淋巴瘤 (ML )发病的关系。方法 采用配对病例 -对照研究设计方案。病例组 :97例确诊的淋巴瘤病例。对照组 A :194例按性别、年龄因素配对的同期随机选择的非肿瘤病例。对照组 B(EB病毒对照组 ) :其它非肿瘤病例 80例。采用酶联免疫法 (EL ISA法 )检测丙型肝炎病毒 (HCV)、人类免疫缺陷病毒 (HIV )、巨细胞病毒 (CMV)和乙型肝炎病毒 (HBV )抗体及抗原。用 EBER原位杂交法 (EBER- ISH )检测病理组织中 EB病毒 (EBV)。结果 EBV阳性率 ML组 70 .1% (6 8/ 97) ,对照组 7.5 % (6 / 80 ) ,OR=6 .5 8,95 % CI:16 .16 4～ 82 .84 6 ,P=0 .0 0 0 1。病例组与对照组感染 HCV、CMV、HBV差异的 P值分别为 0 .2 6 0、0 .2 5 8、0 .6 74(HBV小三阳 )、0 .399(HBV大三阳 )、0 .74 4 (HBV表面抗体阳性 )。 HIV病例组与对照组均无阳性检出。结论 本地区 EBV感染与淋巴瘤发病有相关性 ,而 HCV、HBV、HIV和

Objective To evaluate the relationships between the viruses infections and the incidence of malignant lymphomas(ML) in Sichuan province. Methods A hospital-based paired case-control study was designed with two controls per case. The case group comprised 97 cases diagnosed as ML by pathological examination; the control group A consisted of 194 subjects randomly selected from those with non-malignancies by matching on both gender and age in the corresponding period. Additionally, a control group B for Epstein-Barr virus(EBV), including 80 subjects, were chosen from other non-malignant diseases at the same time. Enzyme-linked immunosorbent assay(ELISA) was employed to test the serum antibodies and antigens of hepatitis C virus (HCV), human immunodeficiency virus (HIV), cytomegalovirus (CMV), and hepatitis B virus (HBV). The EBV was confirmed by the EBER in situ-hybridization (EBER-ISH) of pathological tissue. Results The positive rate of EBV in ML group was 70.1%(68/97) and that of control group was 7.5%(6/80). The difference between these two groups showed a statistical significance by conditional logistic regression analysis(OR=6.58, 95% CI: 16.164-82.846, P=0.0001). The differences in HCV, CMV and HBV infections between case group and control group demonstrated no statistical significance with P-values of 0.260, 0.258 and 0.399 respectively. We found no positive results of HIV antibody in case group and control group. Conclusion The incidence of ML in Sichuan displayed a significant association with EBV infection. However, there were no relationships between the incidence of ML and the HCV, HBV, HIV, CMV infections in the area.