History of allergic disease and risk of meningioma

Eczema as a protective factor for brain cancer: a meta-analysis

BACKGROUND

Brain cancer is one of the most aggressive cancer types owing to poor treatment effects. Epidemiological studies have demonstrated that allergies may increase the disease risk. Therefore, this study evaluated the association between eczema and the risk of various brain cancers.

METHODS

We systematically searched the PubMed and Embase databases from their inception until June 23, 2022. Two reviewers independently reviewed and screened the articles, extracted data, assessed the study quality, and pooled the results. Stata software was used to generate pooled odds ratios and 95% confidence intervals (CIs).

RESULTS

We included 20 studies comprising 5,117,222 patients that investigated the relationship between eczema and brain cancer. Eczema was significantly inversely associated with the risk of brain cancer (odds ratio [OR], 0.82; 95% CI, 0.77-0.87), glioma (OR, 0.53; 95% CI, 0.14-2.02), meningioma (OR, 0.74; 95% CI, 0.66-0.84), and acoustic neuroma (OR, 0.60; 95% CI, 0.41-0.88). Interesting, The strong correlation between eczema and the reduced risk of brain cancer was observed in people over 16 years old (OR, 0.79; 95% CI, 0.71-0.88), but not in those under 16 years old (OR, 0.94; 95% CI, 0.79-1.11). In addition, subgroup analyses found that eczema significantly decreased the glioma risk in Europeans (OR, 0.73; 95% CI, 0.65-0.82) but not Australians (OR, 0.53; 95% CI, 0.14-2.02) or Americans (OR, 1.01; 95% CI, 0.69-1.46).

CONCLUSION

Eczema may be considered as a potential protective factor of brain cancer in population aged over 16 years. However, this relationship requires verification using large-scale clinical data.

Noncutaneous and Cutaneous Cancer Risk in Patients With Atopic Dermatitis: A Systematic Review and Meta-analysis

Importance

Impaired skin barrier and aberrant immune function in atopic dermatitis (AD) may alter immune response to malignant cancer. Conflicting data exist on the risk of cancer in patients with AD.

Objective

To assess the risk of noncutaneous and cutaneous cancers in patients with AD compared with the general population without AD.

Data Sources

Studies identified from searches of MEDLINE and Embase that were published from 1946 and 1980, respectively, to January 3, 2019. The following search terms were used: [(exp NEOPLASMS/ OR neoplas*.tw. OR tumo*.tw. OR cancer*.tw. OR malignanc*.tw.) AND (exp Dermatitis, Atopic/ OR (atopic adj1 (dermatit* or neurodermatit*)).tw. OR eczema.tw. OR disseminated OR neurodermatit*.tw.)].

Study Selection

Included were observational studies (cohort and case-control designs) reporting a risk estimate for cancer in patients with AD compared with a control group (general population or patients without AD).

Data Extraction and Synthesis

Two independent reviewers extracted data and assessed the risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) assessment tool, modified for observational exposure studies. Data were pooled using a random-effects model and expressed as standardized incidence ratios (SIRs) or odds ratios (ORs) with 95% CIs. Heterogeneity was assessed using the Cochrane Q statistic and the I2 statistic.

Main Outcomes and Measures

The main outcome of the study was risk of cancer measured by SIRs or ORs.

Results

This systematic review and meta-analysis included 8 population-based cohort studies (n = 5 726 692 participants) and 48 case-control studies (n = 114 136 participants). Among cohort studies, a statistically significant association was found between AD and keratinocyte carcinoma (5 studies; pooled SIR, 1.46; 95% CI, 1.20-1.77) as well as cancers of the kidney (2 studies; pooled SIR, 1.86; 95% CI, 1.14-3.04), central nervous system (2 studies; pooled SIR, 1.81; 95% CI, 1.22-2.70), and pancreas (1 study; SIR, 1.90; 95% CI, 1.03-3.50). Among 48 case-control studies, pooled effects showed patients with AD had statistically significantly lower odds of central nervous system cancers (15 studies; pooled OR, 0.76; 95% CI, 0.70-0.82) and pancreatic cancer (5 studies; pooled OR, 0.81; 95% CI, 0.66-0.98), contrary to the higher incidence found in cohort studies. Case-control studies also demonstrated lower odds of lung and respiratory system cancers (4 studies; pooled OR, 0.61; 95% CI, 0.45-0.82). No evidence of association was found between AD and other cancer types, including melanoma. There was substantial heterogeneity between studies for many other cancers, which precluded pooling of data, and there was moderate to serious risk of bias among included studies.

Conclusions and Relevance

Observational evidence suggests potential associations between AD and increased risk of keratinocyte carcinoma and kidney cancer as well as lower odds of lung and respiratory system cancers. Further research is needed to address the heterogeneity and limitations of current evidence and to better understand the mechanisms underlying a possible association between AD and cancer risk.

Polymorphism of the IL13 gene may be associated with Uterine leiomyomas in Slovenian women

Uterine leiomyomas (ULM) are a common cause of solid pelvic tumors in women. Their etiopathogenesis remains unclear. Interleukins (ILs) and their receptors can influence tumor biology of ULM. The aim of this study was to evaluate single nucleotide polymorphisms (SNPs) exhibited in the genes IL4 (rs2070874), IL4R (rs1801275), IL12RB1 (rs11575934), IL12B (rs6887695), IL13 (rs20541) and IL23R (rs7517847) as risk factors for ULM in Slovenian women and to identify associations between corresponding clinical parameters and the analyzed SNPs. In addition, solitary and multiple ULM were compared to identify clinical and/or genetic parameters influencing their occurrence. We conducted a case-control study that included 181 women with leiomyomas and 133 control subjects. Genotyping of selected SNPs was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and high resolution melting (HRM) techniques. The TT genotype of rs20541 (IL13) was significantly associated with decreased risk of ULM compared to both the CC and CT genotypes [p = 0.018; odds ratio (OR) = 0.184; 95% confidence interval (95% CI) = 0.048-0.7121. Using genetic and clinical data to develop a predictive model with logistic regression, we found that adenomyosis, higher age at diagnosis, family history of ULM occurrence, earlier menarche, lower number of pregnancies and lower age at first sexual intercourse, the G allele and genotypes AG and GG of rs1801275 (IL4R) were associated with an increased risk of multiple ULM occurrence. We also found an association between rs20541 (IL13) and 17ß-estradiol serum levels in patients with multiple ULM (p 0.003). Our study showed, for the first time, that rs20541 (IL13) may contribute to susceptibility of ULM development and that rs1801275 (IL4R) can predispose patients to develop multiple ULM.

Allergy reduces the risk of meningioma: a meta-analysis

Meningiomas are the most common brain tumours; however, little is known regarding their aetiology. The data are inconsistent concerning atopic disease and the risk of developing meningioma. Thus, we conducted a meta-analysis to investigate the association between allergic conditions and the risk of developing meningioma. A systematic literature search was conducted using PubMed and Web of SCI from Jan 1979 to Feb 2016. Two investigators independently selected the relevant articles according to the inclusion criteria. Eight case-control studies and 2 cohort studies were included in the final analysis, comprising 5,679 meningioma cases and 55,621 control subjects. Compared with no history of allergy, the pooled odds ratio (OR) for allergic conditions was 0.81 (0.70-0.94) for meningioma in a random-effects meta-analysis. Inverse correlations of meningioma occurrence were also identified for asthma and eczema, in which the pooled ORs were 0.78 (0.70-0.86) and 0.78 (0.69-0.87), respectively. A reduced risk of meningioma occurrence was identified in hay fever; however, the association was weak (0.88, 95% CI = 0.78-0.99). The source of this heterogeneity could be the various confounding variables in individual studies. Overall, the current meta-analysis indicated that allergy reduced the risk of developing meningiomas. Large cohort studies are required to investigate this relationship.

Temporal bone meningioma involving the middle ear: A case report

Meningioma is a common intracranial tumor involving the meninges. The localization of this type of tumor is rarely extracranial due to its typically low invasive properties. Furthermore, invasion of the middle ear is exceptional. The present study reported a case of meningioma extending into the middle ear from the middle cranial fossa through the tegmen tympani. The clinical and pathological characteristics, as well as the outcome of the patient, were described.

Association of the interleukin-4Rα rs1801275 and rs1805015 polymorphisms with glioma risk

Potential single-nucleotide polymorphisms (SNPs) of interleukin-4 receptor alpha (IL-4Rα) rs1801275 and rs1805015 have been implicated in glioma risk; however, the findings of previous published case-control studies are conflicting and inconclusive. We performed the updated meta-analysis with the aim to provide a more precise estimate for the role of interleukin-4Rα SNPs in glioma risk. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the strength of the gene association. Overall, the pooled analysis showed that the IL-4Rα rs1801275 polymorphism was associated with a decreased risk of glioma in the comparison of G vs. A (OR = 0.87, 95% CI = 0.76-0.99, P OR = 0.041). Subgroup analysis by ethnicity revealed that the IL-4Rα rs1801275 variant G and GG + AG exerted a decreased risk effect on the development of glioma among Asians, but not Caucasians (G vs. A, OR = 0.81, 95% CI = 0.69-0.95, P OR = 0.011; GG + AG vs. AA, OR = 0.80, 95% CI = 0.66-0.96, P OR = 0.018). However, the IL-4Rα rs1805015 polymorphism did not modify the risk of glioma. Sensitivity analysis confirmed the reliability for all of the results. Our meta-analysis suggests that the polymorphism of IL-4Rα rs1801275 but not IL-4Rα rs1805015 plays a protective role in the glioma pathogenesis, particularly among Asians.

Hormone replacement therapy increases the risk of cranial meningioma

AIM

We investigated the influence of hormone replacement therapy (HRT) use on the risk of meningioma in a population-based setting.

METHODS

We conducted a nationwide case-control study in Denmark based on population-based administrative and health registries. The study included all female patients aged 55-84 years with a first time diagnosis of meningioma during 2000-2009. The cases were matched on birth year with female population controls. Ever use of HRT since 1995 was defined as ≥2 HRT prescriptions and categorised according to HRT type (oestrogen only, combined oestrogen-progestagen, and progestagen only) and cumulated duration of use (<1, ≥1 to <5, ≥5 to <10, ≥10 years). We used conditional logistic regression to compute odds ratios (ORs), with 95% confidence intervals (CIs), for meningioma associated with HRT use, and adjusting for potential confounders.

RESULTS

We identified 924 cases and 6122 controls. Ever use of HRT was associated with an increased risk of meningioma (OR, 1.3; 95%CI, 1.1-1.5) compared with non-use (0-1 prescriptions). The risk increased with increasing duration of HRT use, reaching an OR of 1.7 (95% CI, 1.2-2.3) after more than 10 years of use. The risk of meningioma associated with long-term (≥10 years) HRT use was most pronounced for combined oestrogen-progestagen therapy (OR, 2.2; 95% CI, 1.4-3.3), especially when this regimen constituted the sole HRT therapy (OR, 2.7; 95% CI, 0.9-7.5), although the latter estimate was based on small numbers.

CONCLUSIONS

Long-term HRT use, particularly of combined oestrogen-progestagen therapy, may increase the risk of meningioma.

Allergy and brain tumors in the INTERPHONE study: pooled results from Australia, Canada, France, Israel, and New Zealand

PURPOSE

A history of allergy has been inversely associated with several types of cancer although the evidence is not entirely consistent. We examined the association between allergy history and risk of glioma, meningioma, acoustic neuroma, and parotid gland tumors using data on a large number of cases and controls from five INTERPHONE study countries (Australia, Canada, France, Israel, New Zealand), to better understand potential sources of bias in brain tumor case-control studies and to examine associations between allergy and tumor sites where few studies exist.

METHODS

A total of 793 glioma, 832 meningioma, 394 acoustic neuroma, and 84 parotid gland tumor cases were analyzed with 2,520 controls recruited during 2000-2004. Conditional logistic regression models were used to obtain odds ratios (ORs) and 95 % confidence intervals (CIs) for associations between self-reported allergy and tumor risk.

RESULTS

A significant inverse association was observed between a history of any allergy and glioma (OR = 0.73, 95 % CI 0.60-0.88), meningioma (OR = 0.77, 95 % CI 0.63-0.93), and acoustic neuroma (OR = 0.64, 95 % CI 0.49-0.83). Inverse associations were also observed with specific allergic conditions. However, inverse associations with asthma and hay fever strengthened with increasing age of allergy onset and weakened with longer time since onset. No overall association was observed for parotid gland tumors (OR = 1.21, 95 % CI 0.73-2.02).

CONCLUSIONS

While allergy history might influence glioma, meningioma, and acoustic neuroma risk, the observed associations could be due to information or selection bias or reverse causality.

Assessment of autoantibodies to meningioma in a population-based study

Meningioma is an intracranial tumor with few confirmed risk factors. Recent research points to an impact on meningioma risk from factors related to immune function and development, such as allergy, immunoglobulin E, and Varicella infection status. To further explore an association with immune function, the authors assessed individual seroreactivity to meningioma tumor-associated antigens among participants enrolled in a multicenter, population-based US case-control study of meningioma (2006-2009). Serum samples from cases (n = 349) and controls (n = 348) were screened for autoantibody reactivity to 3 proteins identified in previous studies: enolase 1 (ENO1), NK-tumor recognition protein (NKTR), and nuclear mitotic apparatus protein 1 (NUMA1). Case-control differences were not strong overall (adjusted odds ratio (OR)(ENO1 (continuous)) = 1.1, 95% confidence interval (CI): 0.6, 1.9 (P(trend) = 0.3); adjusted OR(NKTR (continuous)) = 1.3, 95% CI: 0.7, 2.4 (P(trend) = 0.02); and adjusted OR(NUMA1 (continuous)) = 1.1, 95% CI: 0.7, 1.8 (P(trend) = 0.06)); however, antibodies to NKTR and NUMA1 were detected at higher levels in cases than in controls, particularly among men (for men, adjusted OR(ENO1 (continuous)) = 1.6, 95% CI: 0.5, 4.7 (P(trend) = 0.24); adjusted OR(NKTR (continuous)) = 4.3, 95% CI: 1.2, 15 (P(trend) = 0.009); and adjusted OR(NUMA1 (continuous)) = 3.6, 95% CI: 1.1, 11 (P(trend) = 0.006)). These results indicate that men with meningioma commonly react with a serologic antimeningioma response; if supported by further research, this finding suggests a distinctive etiology for meningioma in men.

Primary brain tumours and specific serum immunoglobulin E: a case-control study nested in the European Prospective Investigation into Cancer and Nutrition cohort

BACKGROUND

Case-control studies suggest that patients with allergic diseases have a lower risk of developing glioma but not meningioma or schwannoma. However, those data can be differentially biased. Prospective studies with objective measurements of immunologic biomarkers, like immunoglobulin E (IgE), in blood obtained before cancer diagnosis could help to clarify whether an aetiological association exists.

METHODS

The present case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) measured specific serum IgE as a biomarker for the most common inhalant allergens in 275 glioma, 175 meningioma and 49 schwannoma cases and 963 matched controls using the ImmunoCAP specific IgE test. Subjects with an IgE level ≥0.35 kUA/l (kilo antibody units per litre) were classified as sensitized by allergens. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by adjusted conditional logistic regression models for each tumour subtype. The effect of dose-response relationship was assessed in five increasing IgE level categories to estimate P-values for trend.

RESULTS

The risk of glioma was inversely related to allergic sensitization (OR = 0.73; 95% CI 0.51-1.06), especially pronounced in women (OR = 0.53; 95% CI 0.30-0.95). In dose-response analyses, for high-grade glioma, the lowest OR was observed in sera with the highest IgE levels (P for trend = 0.04). No association was seen for meningioma and schwannoma.

CONCLUSION

The results, based on serum samples prospectively collected in a cohort study, provide some support for the hypothesis that individuals with allergic sensitization are at reduced risk of glioma and confirm results from previous case-control studies.

Family and personal medical history and risk of meningioma

OBJECT

Little is known about the epidemiology of meningioma, the most frequently reported primary brain tumor in the US. The authors undertook a case-control study to examine the relationship between family and personal medical history and meningioma risk.

METHODS

The authors compared the personal and first-degree family histories of 1124 patients with meningioma (age range 20-79 years) in Connecticut, Massachusetts, North Carolina, the San Francisco Bay Area, and 8 Houston counties between May 1, 2006, and February 26, 2010, and the histories of 1000 control individuals who were frequency-matched for age, sex, and geography.

RESULTS

The patients were more likely than the controls to report a first-degree family history of meningioma (OR 4.4, 95% CI 1.6-11.5), and there was an even stronger association in younger cases. The patients were less likely than controls to report immune conditions including allergy (OR 0.6, 95% CI 0.5-0.7) but were more likely to report a history of thyroid cancer (OR 4.7, 95% CI 1.02-21.5) or leukemia (OR 5.4, 95% CI 1.2-24.1) (most after radiotherapy). Among women, patients were more likely than controls to report hormonally related conditions--uterine fibroid tumors (OR 1.2, 95% CI 1.0-1.5), endometriosis (OR 1.5, 95% CI 1.5-2.1), and breast cancer (OR 1.4, 95% CI 0.8-2.3).

CONCLUSIONS

The influence of genetics, the immune system, and radiation near the head on meningioma risk is suggested in the authors' findings; the role of hormones is intriguing but requires further study.

Inverse association between eczema and meningioma: a meta-analysis

BACKGROUND AND PURPOSE

The pathogenesis of primary brain tumors may be related to immune response. Prior studies have shown a strong association between allergy and glioma; however, so far no significant association has been established between allergy and meningioma. Here, we conducted a meta-analysis of published studies to investigate the association of meningioma with the overall and specific allergic conditions.

METHODS

PubMed, EMBASE database, and Cochrane Library were searched for pertinent citations published between January 1979 and October 2009. We used the following searching strategy (brain tumor [Text Word] OR meningioma [Text Word]) AND (allergy [Text Word] OR atopy [Text Word] OR asthma [Text Word] OR eczema [Text Word] OR hay fever [Text Word]) to search for relevant studies. Random effect model was used to estimate the association between allergic conditions and meningioma.

RESULT

A total of 7 studies (5 case-control studies and 2 cohort studies) were included in the analysis, involving 54,391 participants, of whom 2,656 had meningioma. When compared to non-allergic conditions, the pooled odds ratio (OR) with any allergic conditions for meningioma was 0.91 (95% CI: 0.79-1.04, p = 0.163), suggesting that there is no significant association between meningioma and allergic conditions. Interestingly, further analysis showed that eczema had significantly inverse association with meningioma (OR, 0.75; 95% CI: 0.65-0.87, p < 0.05). On the other hand, no significant association was found for asthma (OR, 0.88; 95% CI: 0.75-1.04, p = 0.126) and hay fever (OR, 0.90; 95% CI: 0.79-1.03, p = 0.137).

CONCLUSION

In conclusion, there was a significantly negative association between eczema and meningioma, suggesting that eczema may reduce the risk of meningioma. Although it was not statistically significant association between meningioma and other specific allergic conditions such as asthma and hay fever, further studies with large sample size may be needed to determine its relationship.

Reduced allergy and immunoglobulin E among adults with intracranial meningioma compared to controls

Meningioma, the most frequent tumor in the central nervous system, has few recognized risk factors. We explored the role of allergies in a population-based case-control consortium study of meningioma in five geographic areas. We also studied serum levels of a marker of atopic allergy (IgE) in a subset of study participants, a first for a study on meningioma. Participants (N = 1,065) with surgically resected, pathologically confirmed meningioma and controls (N = 634) selected via random-digit dialing were recruited and interviewed. Cases were less likely than controls to report history of physician-diagnosed allergy [odds ratio (OR) = 0.64; 95% confidence interval (95% CI): 0.51-0.80]. Also, cases (N = 295) had lower total serum IgE than controls [N = 192; OR = 0.85, 95% CI: 0.75-0.98 for each unit of Ln(IgE)]. Similar to glioma and cancers at several other sites, meningioma appears to have an inverse relationship with history of allergies and a biomarker of atopic allergy. As some common opposing predisposition or developmental processes for allergy and meningioma may exist, further research into immune processes that can affect the incidence and natural history of meningioma is warranted.

Annual report to the nation on the status of cancer, 1975-2007, featuring tumors of the brain and other nervous system

Background

The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year’s report highlights brain and other nervous system (ONS) tumors, including nonmalignant brain tumors, which became reportable on a national level in 2004.

Methods

Cancer incidence data were obtained from the National Cancer Institute, CDC, and NAACCR, and information on deaths was obtained from the CDC’s National Center for Health Statistics. The annual percentage changes in age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers for men and for women were estimated by joinpoint analysis of long-term (1992–2007 for incidence; 1975–2007 for mortality) trends and short-term fixed interval (1998–2007) trends. Analyses of malignant neuroepithelial brain and ONS tumors were based on data from 1980–2007; data on nonmalignant tumors were available for 2004–2007. All statistical tests were two-sided.

Results

Overall cancer incidence rates decreased by approximately 1% per year; the decrease was statistically significant (P < .05) in women, but not in men, because of a recent increase in prostate cancer incidence. The death rates continued to decrease for both sexes. Childhood cancer incidence rates continued to increase, whereas death rates continued to decrease. Lung cancer death rates decreased in women for the first time during 2003–2007, more than a decade after decreasing in men. During 2004–2007, more than 213 500 primary brain and ONS tumors were diagnosed, and 35.8% were malignant. From 1987–2007, the incidence of neuroepithelial malignant brain and ONS tumors decreased by 0.4% per year in men and women combined.

Conclusions

The decrease in cancer incidence and mortality reflects progress in cancer prevention, early detection, and treatment. However, major challenges remain, including increasing incidence rates and continued low survival for some cancers. Malignant and nonmalignant brain tumors demonstrate differing patterns of occurrence by sex, age, and race, and exhibit considerable biologic diversity. Inclusion of nonmalignant brain tumors in cancer registries provides a fuller assessment of disease burden and medical resource needs associated with these unique tumors.

Epidemiology and etiology of meningioma

Although most meningiomas are encapsulated and benign tumors with limited numbers of genetic aberrations, their intracranial location often leads to serious and potentially lethal consequences. They are the most frequently diagnosed primary brain tumor accounting for 33.8% of all primary brain and central nervous system tumors reported in the United States between 2002 and 2006. Inherited susceptibility to meningioma is suggested both by family history and candidate gene studies in DNA repair genes. People with certain mutations in the neurofibromatosis gene (NF2) have a very substantial increased risk for meningioma. High dose ionizing radiation exposure is an established risk factor for meningioma, and lower doses may also increase risk, but which types and doses are controversial or understudied. Because women are twice as likely as men to develop meningiomas and these tumors harbor hormone receptors, an etiologic role for hormones (both endogenous and exogenous) has been hypothesized. The extent to which immunologic factors influence meningioma etiology has been largely unexplored. Growing emphasis on brain tumor research coupled with the advent of new genetic and molecular epidemiologic tools in genetic and molecular epidemiology promise hope for advancing knowledge about the causes of intra-cranial meningioma. In this review, we highlight current knowledge about meningioma epidemiology and etiology and suggest future research directions.

Risk of meningioma and common variation in genes related to innate immunity

BACKGROUND

The etiology of meningioma, the second most common type of adult brain tumor in the United States, is largely unknown. Prior studies indicate that history of immune-related conditions may affect the risk of meningioma.

METHODS

To identify genetic markers for meningioma in genes involved with innate immunity, we conducted an exploratory association study of 101 meningioma cases and 330 frequency-matched controls of European ancestry using subjects from a hospital-based study conducted by the National Cancer Institute. We genotyped 1,407 "tag" single nucleotide polymorphisms (SNP) in 148 genetic regions chosen on the basis of an r2>0.8 and minor allele frequency of >5% in Caucasians in HapMap1. Risk of meningioma was estimated by odds ratios and 95% confidence intervals.

RESULTS

Seventeen SNPs distributed across 12 genetic regions (NFKB1 (3), FCER1G (3), CCR6 (2), VCAM1, CD14, TNFRSF18, RAC2, XDH, C1D, TLR1/TLR10/TLR6, NOS1, and DEFA5) were associated with the risk of meningioma with P<0.01. Although individual SNP tests were not significant after controlling for multiple comparisons, gene region-based tests were statistically significant (P<0.05) for TNFRSF18, NFKB1, FCER1G, CD14, C1D, CCR6, and VCAM1.

CONCLUSIONS AND IMPACT

Our results indicate that common genetic polymorphisms in innate immunity genes may be associated with risk of meningioma. Given the small sample size, replication of these results in a larger study of meningioma is needed.

Childhood and juvenile meningiomas

PURPOSE

The purpose of this paper was to study the clinical characteristic, treatment, and prognosis of childhood meningioma.

MATERIALS AND METHODS

Fifty-four meningioma cases below the age of 18 have been treated in Huashan Hospital in the last 15 years (from 1993 to 2008), their sex and age distribution, clinical manifestation, radiological finding, pathological subtype, treatment, and prognosis are retrospectively analyzed, and the results are compared with those reported in the literature.

RESULTS

The ratio of male to female was 1.16:1 (29:25) and mean age was 13.14 years (ranging from 2.75 to 18 years). Five patients in this series were associated with neurofibromatosis-2. The most common symptoms and signs were the signs of increased intracranial pressure including headache, papilledema, and vomiting. The most common radiological finding was homogeneous enhancement with contrast. The most common locations of meningiomas in this series were intraventricular and anterior/middle fossa. All of these patients were surgically treated; resection both in Simpson grades I and II could be achieved in 39 out of 54 patients. Perioperative mortality was 3.7% (2 out of 54); the most common postoperative complications were intracranial infection and injury of cranial nerve. Fibroblastic meningiomas were the most common pathological subtype, and malignant and atypical meningiomas (both of grades II and III according to WHO classification) accounted for 18.5% of the whole series.

CONCLUSION

Childhood meningiomas are scarce in clinical practice, which are characterized with its male predominance, large size, distinctive radiological features, and high rate of atypical/malignant histological subtypes; favorable outcome is accessible with total removal.

History of allergic disease and epilepsy and risk of glioma and meningioma (INTERPHONE study group, Germany)

The aim of the present analysis was to examine the association of a medical history of asthma, hay fever, eczema, or epilepsy with the risk of glioma and meningioma. Data of a German population-based case-control study included 381 meningioma cases, 366 glioma cases, and 1,494 controls. Participants' histories of asthma, hay fever, eczema, and epilepsy and the respective ages at onset were asked during a personal interview. A small inverse association between allergic condition and both glioma (odds ratio: 0.92; 95% CI: 0.70-1.22) and meningioma (odd ratio: 0.87; 95% CI: 0.66-1.14) was found. For glioma, this inverse association was more pronounced in persons reporting to have asthma compared to other allergic conditions. The positive association between epilepsy and particularly glioma suggests that epilepsy is an early symptom of the disease. As the association was seen also for epilepsies occurring more than a decade before the diagnosis of glioma, this might indicate either an aetiological role of epilepsy, or a relatively long preclinical phase. In conclusion our study confirms previous findings of case control studies but not those from cohort studies. However, possible selection bias in case control studies might not explain the different results in its entirety.

An international case-control study of interleukin-4Ralpha, interleukin-13, and cyclooxygenase-2 polymorphisms and glioblastoma risk

Previous studies found that allergies are inversely related to risk of glioma. In an earlier publication, using data from a Swedish case-control study, Schwartzbaum et al. report an inverse relation between risk of glioblastoma and four single nucleotide polymorphisms (SNP) on two genes [interleukin (IL)-4Ralpha, IL-13] that are associated with allergies. In addition, recent studies suggest that IL-4 and IL-13 induce cyclooxygenase-2 (COX-2) to resolve brain inflammation. To see whether previous Swedish results (110 cases, 430 controls) would be replicated, we estimated the association between glioblastoma and two IL-4Ralpha (rs1805015, rs1801275) and two IL-13 (rs20541, rs1800925) SNPs and their haplotypes and one COX-2 SNP (-765GC) using additional English, Danish, and Finnish data (217 cases, 1,171 controls). Among general population controls, we evaluated associations between these haplotypes, the COX-2 SNP, and self-reported allergies. Our data did not support our original observations relating individual IL-4Ralpha, IL-13, or COX-2 SNPs to glioblastoma risk. However, the T-G IL-4Ralpha haplotype was associated with glioblastoma risk (odds ratio, 2.26; 95% confidence interval, 1.13-4.52) and there was a suggestion of an inverse relation between this haplotype and hayfever prevalence among controls (odds ratio, 0.38; 95% confidence interval, 0.14-1.03). The lack of support for a link between four IL-4Ralpha and IL-13 SNPs and glioblastoma may reflect the absence of associations or may result from uncontrolled confounding by haplotypes related both to those that we examined and glioblastoma. Nonetheless, the association between the T-G IL-4Ralpha haplotype and glioblastoma risk may indicate a role of immune factors in glioblastoma development.

Comprehensive analysis of DNA repair gene variants and risk of meningioma

BACKGROUND

Meningiomas account for up to 37% of all primary brain tumors. Genetic susceptibility to meningioma is well established, with the risk among relatives of meningioma patients being approximately threefold higher than that in the general population. A relationship between risk of meningioma and exposure to ionizing radiation is also well known and led us to examine whether variants in DNA repair genes contribute to disease susceptibility.

METHODS

We analyzed 1127 tagging single-nucleotide polymorphisms (SNPs) that were selected to capture most of the common variation in 136 DNA repair genes in five case-control series (631 case patients and 637 control subjects) from four countries in Europe. We also analyzed 388 putative functional SNPs in these genes for their association with meningioma. All statistical tests were two-sided.

RESULTS

The SNP rs4968451, which maps to intron 4 of the gene that encodes breast cancer susceptibility gene 1-interacting protein 1, was consistently associated with an increased risk of developing meningioma. Across the five studies, the association was highly statistically significant (trend odds ratio = 1.57, 95% confidence interval = 1.28 to 1.93; P(trend) = 8.95 x 10(-6); P = .009 after adjusting for multiple testing).

CONCLUSIONS

We have identified a novel association between rs4968451 and meningioma risk. Because approximately 28% of the European population are carriers of at-risk genotypes for rs4968451, the variant is likely to make a substantial contribution to the development of meningioma.

Atopic dysfunction and risk of central nervous system tumours in children

Risk factors for central nervous system (CNS) tumours in children remain largely unknown. Evidence of an inverse relationship between atopy and tumour development exists in adults but little is known about childhood tumours. This study aims to examine the risk of childhood CNS tumours given a history of eczema and asthma. Cases of children diagnosed with CNS tumours (n=575) and controls (n=6292) from the UK Childhood Cancer Study (UKCCS) were analysed using conditional logistic regression comparing reported histories of allergic disease. Asthma was statistically significantly and negatively associated with all CNS tumours (odds ratios, OR 0.75, confidence of interval, CI(95%): 0.58-0.97), though this was not observed for eczema (OR 0.94, CI(95%): 0.74-1.18). Individuals who had suffered both asthma and eczema showed the most significant reduction in risk (OR 0.48, CI(95%): 0.28-0.81). Analysis by tumour subtype showed the strongest effect for the medulloblastoma/PNET group. These results may have a biological explanation with raised immunosurveillance in atopic individuals protecting against the development of brain tumours. Alternative explanations might include bias, reverse causality or confounding.

Atopy and risk of brain tumors: a meta-analysis

BACKGROUND

Glioma is a rapidly progressive disease, and little is known about its etiology. Atopic diseases are on the rise in western populations, with increasing interest on their long-term health consequences. An inverse association between atopy and the risk of glioma has been observed. We carried out a meta-analysis of studies examining the association between atopic disease and risk of glioma and meningioma.

METHODS

In an electronic literature search of the MEDLINE, ISI Web of Science, and EMBASE databases from 1979 through February 2007, we identified case-control and cohort studies quantifying associations between a history of asthma, eczema, or hay fever or allergy and a medically confirmed diagnosis of glioma or meningioma. We performed meta-analysis by pooling studies according to the inverse of their variances. We evaluated publication bias using funnel plot and sensitivity analyses.

RESULTS

A total of eight observational studies were included, with a total of 3450 patients diagnosed with glioma and 1070 patients with meningioma. A history of atopic disease was inversely related to risk of glioma. The pooled relative risks (RRs) of glioma comparing those with a history of an atopic condition with those with no history of that condition were 0.61 (95% confidence interval [CI] = 0.55 to 0.67) for allergy, 0.68 (95% CI = 0.58 to 0.80) for asthma, and 0.69 (95% CI = 0.58 to 0.82) for eczema. Proxy reporting was unlikely to explain the association because the pooled relative risk estimate from studies without proxy reporting remained inverse and statistically significant (RR = 0.66, 95% CI = 0.58 to 0.75). Publication bias was also an unlikely explanation for the inverse association because the association persisted in a sensitivity analysis and the funnel plot was symmetric. No overall statistically significant association was noted for atopy and meningioma, although the information on this disease was limited and heterogeneous.

CONCLUSIONS

We observed a strong inverse relationship between atopic disease and glioma that is unlikely to be explained by methodologic bias alone.

The INTERPHONE study: design, epidemiological methods, and description of the study population

The very rapid worldwide increase in mobile phone use in the last decade has generated considerable interest in the possible health effects of exposure to radio frequency (RF) fields. A multinational case-control study, INTERPHONE, was set-up to investigate whether mobile phone use increases the risk of cancer and, more specifically, whether the RF fields emitted by mobile phones are carcinogenic. The study focused on tumours arising in the tissues most exposed to RF fields from mobile phones: glioma, meningioma, acoustic neurinoma and parotid gland tumours. In addition to a detailed history of mobile phone use, information was collected on a number of known and potential risk factors for these tumours. The study was conducted in 13 countries. Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the UK using a common core protocol. This paper describes the study design and methods and the main characteristics of the study population. INTERPHONE is the largest case-control study to date investigating risks related to mobile phone use and to other potential risk factors for the tumours of interest and includes 2,765 glioma, 2,425 meningioma, 1,121 acoustic neurinoma, 109 malignant parotid gland tumour cases and 7,658 controls. Particular attention was paid to estimating the amount and direction of potential recall and participation biases and their impact on the study results.