Berstein L M, Zimarina T S, Tsyrlina E V, Kovalevskiĭ A Iu, Imianitov E N
N.N. Petrov Research Institute of Oncology, Ministry of Health of the RF, St. Petersburg.
Vopr Onkol. 2004;50(2):169-73.
The strategy of therapy and prognosis of reproductive system neoplasia generally depend on the steroid receptor status of tumor. The causes of formation of steroid receptor-free tumors are to be investigated. The genetic polymorphism of CYP19 (aromatase), CYP17 (17-hydroxylase; 17,20-lyase), CYP1B1 (4-estrogen hydroxylase) and COMT (catechol-O-methyl transferase) was studied in a total of 254 patients with breast and endometrial cancer, with particular reference to the association of certain polymorphisms and receptor status of tumor. It was found that the lack of estrogen receptor (ER) in breast tumor was due to a deficit in the A3A6 allele (p(0.01), while the absence of progesterone receptors was associated with a lower incidence of the A1A1 and A1A2 variants (p = 0.022) of tetranucleotide repeats in the CYP19 gene. In the same patients, receptor-negative tumors occurred more often (p = 0.032) than in combinations of higher level of 4-hydroxylase estradiol of S-allele in position 48 (Gly/Arg) of the CYP1B1 gene. Moreover, endometrial carcinoma patients tended to reveal (p = 0.058) an increased ratio of A6A7-CYP19 to allele A1-containing variant. No other distinctions between R(+) and R(-) tumors were identified. It is suggested that peculiar polymorphisms of steroidogenic enzymes may moderately influence the genesis of R(-) neoplasms which may be associated with either the rate of estrogen biosynthesis or, as in the case of CYP1B1, with formation of genotoxic derivatives of estrogens. The latter point is to be investigated further.
生殖系统肿瘤的治疗和预后策略通常取决于肿瘤的类固醇受体状态。无类固醇受体肿瘤形成的原因有待研究。对254例乳腺癌和子宫内膜癌患者的CYP19(芳香化酶)、CYP17(17-羟化酶;17,20-裂解酶)、CYP1B1(4-雌激素羟化酶)和COMT(儿茶酚-O-甲基转移酶)的基因多态性进行了研究,特别关注某些多态性与肿瘤受体状态的关联。研究发现,乳腺肿瘤中雌激素受体(ER)的缺乏是由于A3A6等位基因缺失(p<0.01),而孕激素受体的缺失与CYP19基因四核苷酸重复序列的A1A1和A1A2变体发生率较低有关(p = 0.022)。在同一组患者中,受体阴性肿瘤的发生率高于CYP1B1基因第48位S等位基因(Gly/Arg)的4-羟化雌二醇水平较高的组合(p = 0.032)。此外,子宫内膜癌患者倾向于表现出(p = 0.058)A6A7-CYP19与含A1等位基因变体的比例增加。在R(+)和R(-)肿瘤之间未发现其他差异。提示类固醇生成酶的特殊多态性可能适度影响R(-)肿瘤的发生,这可能与雌激素生物合成速率有关,或者如CYP1B1的情况,与雌激素的遗传毒性衍生物形成有关。后一点有待进一步研究。