Niell Bethany L, Rennert Gad, Bonner Joseph D, Almog Ronit, Tomsho Lynn P, Gruber Stephen B
Department of Internal Medicine, Division of Molecular Medicine and Genetics, University of Michigan Medical School, Ann Arbor, MI 48109-0638, USA.
J Natl Cancer Inst. 2004 Jan 7;96(1):15-21. doi: 10.1093/jnci/djh008.
Mutations in BRCA1 and/or BRCA2 (BRCA1/2) profoundly increase the risks of breast and ovarian cancers, but it is unclear whether mutations in these genes increase the risk of colorectal cancer. We investigated BRCA1/2 founder mutations and a family history of breast cancer as potential risk factors for colorectal cancer.
In the population-based Molecular Epidemiology of Colorectal Cancer study in northern Israel, 1422 case patients with incident colorectal cancer, diagnosed between March 31, 1998, and December 31, 2002, and 1566 control subjects without colorectal cancer were genotyped for the BRCA1 187delAG, BRCA1 5385insC, and BRCA2 6174delT founder mutations. Genotypes and interview data from all case patients and control subjects and from only those of Ashkenazi Jewish descent (1002 case patients and 1038 control subjects) were used to calculate odds ratios [ORs] from logistic regression.
Twenty-four (2.4%) case patients and 20 (1.9%) control subjects carried one of the three mutations (OR = 1.24, 95% confidence interval [CI] = 0.68 to 2.26). A family history of breast cancer in a female relative was not associated with an increased risk of colorectal cancer, even after adjustment for the presence of a BRCA founder mutation (OR = 1.03, 95% CI = 0.75 to 1.41).
Although weak associations cannot be excluded, Ashkenazi BRCA founder mutations do not confer a strongly elevated risk of colorectal cancer. Similarly, a family history of breast cancer does not appear to be a strong risk factor for colorectal cancer in this population.
BRCA1和/或BRCA2(BRCA1/2)基因的突变会显著增加患乳腺癌和卵巢癌的风险,但尚不清楚这些基因的突变是否会增加患结直肠癌的风险。我们研究了BRCA1/2始祖突变以及乳腺癌家族史作为结直肠癌的潜在危险因素。
在以色列北部基于人群的结直肠癌分子流行病学研究中,对1998年3月31日至2002年12月31日期间确诊的1422例新发结直肠癌病例患者以及1566例无结直肠癌的对照受试者进行了BRCA1 187delAG、BRCA1 5385insC和BRCA2 6174delT始祖突变的基因分型。所有病例患者和对照受试者以及仅具有阿什肯纳兹犹太血统的那些人(1002例病例患者和1038例对照受试者)的基因型和访谈数据用于通过逻辑回归计算比值比[OR]。
24例(2.4%)病例患者和20例(1.9%)对照受试者携带三种突变之一(OR = 1.24,95%置信区间[CI] = 0.68至2.26)。女性亲属的乳腺癌家族史与结直肠癌风险增加无关,即使在调整了BRCA始祖突变的存在之后(OR = 1.03,95% CI = 0.75至1.41)。
虽然不能排除微弱关联,但阿什肯纳兹BRCA始祖突变不会使结直肠癌风险大幅升高。同样,在该人群中,乳腺癌家族史似乎也不是结直肠癌的强危险因素。