Ishitobi Makoto, Miyoshi Yasuo, Ando Akiko, Hasegawa Seiichi, Egawa Chiyomi, Tamaki Yasuhiro, Monden Morito, Noguchi Shinzaburo
Department of Surgical Oncology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
Clin Cancer Res. 2003 Apr;9(4):1376-80.
The association of BRCA2 polymorphisms at codon 372 [Asn (N)/His (H)]and codon 784 [Met (M)/Val (V)] with breast cancer risk was evaluated in Japanese women. In addition, the prognostic significance of these polymorphisms was studied in breast cancer patients.
A case-control study was conducted to examine the association of the BRCA2 N/H372 polymorphism and M/V 784 polymorphism with breast cancer risk (cases = 149, controls = 154). The prognostic significance of these polymorphisms was evaluated in 139 patients with primary breast cancer.
No significant association was observed between the N/H372 polymorphism and breast cancer risk. In contrast, a significant increase in breast cancer risk (odds ratio, 2.03; 95% confidence interval, 1.07-3.87) was observed in carriers of the variant allele (V784) of the M/V784 polymorphism as compared with noncarriers after adjustment for the classical risk factors, age, family history, parity, body mass index, and so forth. Among breast cancer patients, various clinicopathological parameters including menopausal status, tumor size, lymph node status, histological grade, and estrogen-receptor status were not significantly different between the carriers and noncarriers of the variant allele with regard to both N/H372 and M/V784 polymorphisms. The N/H 372 polymorphism was not significantly associated with patient prognosis. On the other hand, breast cancer patients carrying the variant allele of M/V784 polymorphism showed a significantly (P = 0.014) lower 3-year disease-free survival rate (63%) than noncarriers (92%). Multivariate analysis has revealed that the M/V784 polymorphism is a significant prognostic factor, being independent of the other conventional prognostic factors such as lymph node status and estrogen receptor status.
These results suggest that the M/V784 polymorphism, but not the N/H372 polymorphism, would be useful in the selection of women at high risk for developing breast cancer and would also serve as a clinically useful prognostic factor in breast cancer patients.
在日本女性中评估BRCA2基因第372密码子[Asn(N)/His(H)]和第784密码子[Met(M)/Val(V)]的多态性与乳腺癌风险的关联。此外,还研究了这些多态性在乳腺癌患者中的预后意义。
进行了一项病例对照研究,以检验BRCA2基因N/H372多态性和M/V784多态性与乳腺癌风险的关联(病例 = 149例,对照 = 154例)。在139例原发性乳腺癌患者中评估了这些多态性的预后意义。
未观察到N/H372多态性与乳腺癌风险之间存在显著关联。相比之下,在对年龄、家族史、生育情况、体重指数等经典风险因素进行调整后,与非携带者相比,M/V784多态性的变异等位基因(V784)携带者的乳腺癌风险显著增加(优势比,2.03;95%置信区间,1.07 - 3.87)。在乳腺癌患者中,就N/H372和M/V784多态性而言,变异等位基因携带者和非携带者之间的各种临床病理参数,包括绝经状态、肿瘤大小、淋巴结状态、组织学分级和雌激素受体状态,均无显著差异。N/H372多态性与患者预后无显著关联。另一方面,携带M/V784多态性变异等位基因的乳腺癌患者的3年无病生存率(63%)显著低于非携带者(92%)(P = 0.014)。多变量分析显示,M/V784多态性是一个显著的预后因素,独立于其他传统预后因素,如淋巴结状态和雌激素受体状态。
这些结果表明,M/V784多态性而非N/H372多态性,在筛选乳腺癌高危女性中可能有用,并且在乳腺癌患者中也可作为一个具有临床意义的预后因素。