Familial aggregation of oesophageal cancer in a high incidence area in China
Familial aggregation of oesophageal cancer in a high incidence area in China
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DOI：
10.1093/ije/26.6.1159
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发表时间：
1997-12-01
影响因子：
7.7
通讯作者：
Wahrendorf, J
中科院分区：
文献类型：
--
作者：
Chang-Claude, J;Becher, H;Wahrendorf, J
背景中国北方食管癌高发主要是环境因素造成的。遗传因素的作用尚未得到广泛研究。我们的目的是研究中国食管癌高发区一个确定人群的家系中食管癌的家族聚集性，并使用不同的分析方法量化与不同一级亲属相关的风险。对河南省辉县市1987 ~ 1992年中发生的244例食管癌患者进行了家系调查，收集了该家系连续三代成员的详细资料，并对食管癌及其他癌症的发病情况进行了分析。与预期死亡率相比，食管癌患者一级亲属中食管癌的标化死亡比（SMR）为2.4（男性2.2，女性2.7）。一级和二级亲属的相应SMR分别为1.6和2.2。使用二项分布的Tarone单侧评分检验拒绝了“无家族聚集”的零假设，表明家族内聚集的一些证据。为了解释由于对间相关性和家庭和/或个体特定变量引起的方差，我们使用广义估计方程（GEE）方法拟合了一系列回归模型。经性别、年龄和索引病例的性别校正后，父母之间的成对比值比为2.3，兄弟姐妹之间的成对比值比为1.9，兄弟姐妹之间的成对比值比为1.1。研究人群中食管癌的家族聚集性的存在被证实使用不同的分析和一级亲属的风险增加了两到三倍。父母和兄弟姐妹之间疾病的明显关联提供了遗传成分的一些迹象。父母之间的成对关联而不是兄弟姐妹之间的关联表明，环境因素在童年之后有更强的作用。
Background. The high incidence of oesophageal cancer in northern China is attributed predominantly to environmental factors. The role of genetic factors has not been extensively studied.Methods. Our aim was to study familial aggregation of oesophageal cancer in pedigrees from a defined population base in a high incidence area in China and to quantify the risk associated with different first degree relatives using different analytical approaches. Detailed data on family members of three successive generations and the occurrence of oesophageal and other cancers in family members were collected from a population-based series of 244 oesophageal cancer cases which occurred between 1987 and mid-1992 in Huixian County, Henan.Results. Compared to expected rates, the standardized mortality ratio (SMR) of oesophageal cancer among first degree relatives of oesophageal cancer patients was 2.4 (2.2 in male and 2.7 in female relatives). The corresponding SMR for first and second degree relatives were 1.6 and 2.2. The null hypothesis of 'no familiar aggregation' was rejected using Tarone's one-sided score test for binomial distributions indicating some evidence for clustering within families. To account for variance due to between-pairs correlation and family and/or individual specific variables, we fitted a series of regression models using a Generalized Estimation Equations (GEE) approach. The pairwise odds ratios were 2.3 for parent-parent, 1.9 for sib-parent and 1.1 for sib-sib, adjusted for sex, age and sex of index case.Discussion. The existence of familial aggregation of oesophageal cancer in the study population was confirmed using different analyses and a two-to threefold increased risk was found for first degree relatives. The clear association of disease between parent and sib provides some indication of a genetic component. The pairwise association between parents but not between sibs suggests that environmental factors have a stronger action after childhood.