RISK OF CANCER IN RELATIVES OF PROSTATE-CANCER PROBANDS
RISK OF CANCER IN RELATIVES OF PROSTATE-CANCER PROBANDS
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DOI：
10.1093/jnci/87.13.991
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发表时间：
1995-07-05
期刊：
影响因子：
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通讯作者：
WALSH, PC
中科院分区：
文献类型：
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作者：
ISAACS, SD;KIEMENEY, LALM;WALSH, PC
背景：据估计，1995年将有超过244000例新诊断的前列腺癌病例和超过40000名男性死于这种疾病，有证据表明前列腺癌具有遗传易感性，但可归因于一种或多种特定基因遗传的病例比例并不大，一些遗传性癌症综合征涉及多个肿瘤部位，一些研究报道了前列腺癌与其他癌症之间的家族关系，前列腺癌家族中其他癌症的存在可能表明某种特定类型的遗传易感性。目的：我们研究了因为前列腺癌的存在而选择的家系，以确定遗传性前列腺癌是否与其他部位的癌症相关，并可能与其他可遗传癌症综合征相关，方法：对来自两个不同研究人群的数据进行回顾性研究。第一组包括690例非前列腺癌家族史的前列腺癌根治术患者和640名对照患者，他们是患者的配偶或女性伴侣；第二组由75个符合遗传性前列腺癌标准的多个家庭(即有多个前列腺癌病例的家庭)组成，比较病例和对照人群14个癌症聚集组的发生情况，用Poisson回归分析数据，计算相对风险(RR)和它们的95%可信区间(CI)。结果：前列腺癌先证者的兄弟和父亲患前列腺癌的风险显著高于对照受试者的男性一级亲属(RR=1.76；95%CI=1.28-2.43)，因此，前列腺癌患者的一级亲属患前列腺癌的风险比对照组的一级亲属高76%。这一较高的风险并没有被家系中乳腺癌的发生所改变，而且，在遗传家族中发现了具有统计学意义的更高的中枢神经系统肿瘤的风险(RR=3.02；(95%CI=1.08-8.41)，在这些家系中，没有观察到其他主要部位的癌症风险在统计学上显著增加，如乳腺癌、卵巢或子宫内膜，结论：即使在因前列腺癌的存在而特别选择的家系中，其他部位的癌症风险似乎也没有增加，因此，遗传性前列腺癌似乎是一种相对部位特异性的疾病，它似乎不是其他遗传性癌症综合征的一部分。
Background: It is estimated that there will be more than 244000 new prostate cancer cases diagnosed and that more than 40000 men will die of this disease during 1995, Evidence exists for a hereditary predisposition to prostate cancer, but the proportion of cases attributable to the inheritance of a specific gene or genes is not large, Some hereditary cancer syndromes involve more than one tumor site, and some studies have reported a familial association between prostate cancer and other cancers, The presence of other cancers in prostate cancer families may indicate a specific type of hereditary predisposition, Purpose: We studied families that were selected because of the presence of prostate cancer to determine whether hereditary prostate cancer is associated with cancers at other sites and possibly with other heritable cancer syndromes, Methods: Data from two distinct study populations were studied retrospectively. The first population consisted of 690 case patients undergoing radical prostatectomy who were not selected for family history of prostate cancer and 640 control subjects who were the spouses or female companions of the case patients, The second population consisted of 75 multiplex families (i.e., families with multiple cases of prostate cancer) referred because they fulfilled the criteria for hereditary prostate cancer, A comparison between case and control populations for the occurrence of 14 aggregated groups of cancer was performed, Data were analyzed using Poisson regression, and relative risks (RRs) and their 95% confidence intervals (CIs) were calculated, Results: Brothers and fathers of prostate cancer probands have a statistically significant higher risk of prostate cancer than the male first-degree relatives of control subjects (RR = 1.76; 95% CI = 1.28-2.43), Therefore, the risk for prostate cancer is 76% higher among first-degree relatives of prostate cancer patients compared with first-degree relatives of control subjects. This higher risk was not modified by an occurrence of breast cancer in the pedigree, Also, a statistically significant higher risk was found for tumors of the central nervous system in hereditary families (RR = 3.02; 95% CI = 1.08-8.41), Statistically significant higher risks of cancer at other major sites, such as breast, ovary, or endometrium were not observed in these families, Conclusion: Even among families that were specifically selected because of the presence of prostate cancer, risks for cancer at other sites appeared not to be increased, Therefore, hereditary prostate cancer appears to be a relatively site-specific disease, and it does not seem to be a part of other hereditary cancer syndromes.