Hemminki Kari, Granström Charlotta
Department of Biosciences at Novum, Karolinska Institute, 141 57 Huddinge, Sweden.
Int J Cancer. 2003 Jul 10;105(5):701-5. doi: 10.1002/ijc.11151.
Age-specific familial risks in ovarian cancer have not been assessed by histologic types of medically verified cancers. We used the nationwide Swedish Family-Cancer Database on 10.2 million individuals and 19,175 invasive and 3,436 borderline ovarian cancers to calculate, by affected family members, standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for familial ovarian cancer in 0-66 year old daughters. SIRs for all invasive ovarian cancer were 2.68 (95% CI 2.22-3.21) by ovarian cancer in mother, 2.94 (1.40-5.94) by an affected sister and 24.03 (6.12-74.46) by both an affected mother and sister. The population-attributable fraction from mothers was 2.52%. Seropapillary cystadenocarcinoma showed the highest familial risk, but the effect of histopathol subtype could not be fully assessed because of lack of data in probands. Age-specific data showed some early-onset components and an unusual maximal incidence in the 40s. A comparison to an earlier study on BRCA1/2 mutation analysis and relative risks of ovarian and breast cancer suggests that these mutations could account for 26% of the familial aggregation of ovarian cancer. Histopathology and age of onset appear to be important attributes of familial ovarian cancer, suggesting that further gene identification efforts should target a specific histopathology in early-onset patients.
卵巢癌的年龄特异性家族风险尚未按经医学验证的癌症组织学类型进行评估。我们使用了瑞典全国性的家庭癌症数据库,该数据库涵盖1020万人,其中有19175例浸润性卵巢癌和3436例交界性卵巢癌,通过受影响的家庭成员,计算0至66岁女儿患家族性卵巢癌的标准化发病率(SIR)和95%置信区间(CI)。母亲患卵巢癌时,所有浸润性卵巢癌的SIR为2.68(95%CI 2.22 - 3.21),姐妹患病时为2.94(1.40 - 5.94),母亲和姐妹均患病时为24.03(6.12 - 74.46)。母亲导致的人群归因分数为2.52%。浆液性乳头状囊腺癌显示出最高的家族风险,但由于先证者数据不足,无法完全评估组织病理学亚型的影响。年龄特异性数据显示出一些早发因素,且在40多岁时出现异常的发病率峰值。与早期一项关于BRCA1/2突变分析以及卵巢癌和乳腺癌相对风险的研究相比,这些突变可能占卵巢癌家族聚集性的26%。组织病理学和发病年龄似乎是家族性卵巢癌的重要特征,这表明进一步的基因鉴定工作应针对早发患者的特定组织病理学。