Pottern L M, Gart J J, Nam J M, Dunston G, Wilson J, Greenberg R, Schoenberg J, Swanson G M, Liff J, Schwartz A G
Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland 20892.
Cancer Epidemiol Biomarkers Prev. 1992 Mar-Apr;1(3):177-82.
To evaluate the possibility that genetic factors contribute to the excess rates of multiple myeloma among blacks, serological typing of human leukocyte antigens (HLA) was conducted for black and white male patients and controls who participated in a large population-based case-control interview study. Forty-six black cases, 88 black controls, 85 white cases, and 122 white controls were typed for the Class I antigens (HLA-A, -B, -C) and for the Class II antigens (HLA-DR, HLA-DQ). Black cases had significantly higher gene frequencies than black controls for Bw65, Cw2, and DRw14, while white cases had higher gene frequencies than white controls for A3 and Cw2 and blanks at the DR and DQ loci. Further analysis of the association between Cw2 and multiple myeloma revealed relative risks of 5.7 (95% confidence interval = 1.5-26.6) and 2.6 (95% confidence interval = 1.0-7.2) for blacks and whites, respectively. The frequency of Cw2 in black and white controls was similar. These findings suggest that the Cw2 allele enhances the risk of myeloma in blacks and whites but do not explain the higher incidence of this cancer among blacks. The study also suggests that undefined DQ antigens may play an etiological role, supporting the need for further research into the immunogenetic determinants of myeloma.
为评估遗传因素导致黑人多发性骨髓瘤发病率过高的可能性，对参与一项大型基于人群的病例对照访谈研究的黑人和白人男性患者及对照进行了人类白细胞抗原（HLA）血清学分型。对46例黑人病例、88例黑人对照、85例白人病例和122例白人对照进行了I类抗原（HLA-A、-B、-C）和II类抗原（HLA-DR、HLA-DQ）的分型。黑人病例中Bw65、Cw2和DRw14的基因频率显著高于黑人对照，而白人病例中A3和Cw2的基因频率高于白人对照，DR和DQ位点为空白。对Cw2与多发性骨髓瘤之间关联的进一步分析显示，黑人的相对风险为5.7（95%置信区间=1.5-26.6），白人为2.6（95%置信区间=1.0-7.2）。黑人和白人对照中Cw2的频率相似。这些发现表明，Cw2等位基因增加了黑人和白人患骨髓瘤的风险，但无法解释黑人中这种癌症较高的发病率。该研究还表明，未明确的DQ抗原可能起病因学作用，支持对骨髓瘤免疫遗传决定因素进行进一步研究的必要性。
