Jones J Shawn, Chi Xuedong, Gu Xiangjun, Lynch Patrick M, Amos Christopher I, Frazier Marsha L
Department of Epidemiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Clin Cancer Res. 2004 Sep 1;10(17):5845-9. doi: 10.1158/1078-0432.CCR-03-0590.
Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant syndrome of familial malignancies. Colorectal and endometrial cancers are most frequently observed. The syndrome results mainly from germ-line mutations in DNA mismatch repair genes. A common G-to-C polymorphism at codon 72 in the p53 gene has been associated with increased risk for lung, nasopharyngeal, oral, prostate, and breast cancers and may be a marker for genetic susceptibility to colorectal cancer. We studied the influence of this p53 polymorphism on HNPCC age of onset.
We determined the p53 genotype of 92 Caucasian mismatch repair mutation carriers, of which, 47 had colorectal cancer. The subjects were genotyped by single-strand conformational polymorphism analysis. We tested the association between age of onset and the p53 genotypes by comparing Kaplan-Meier survival curves, evaluating the homogeneity of the curves using the log-rank test and Wilcoxon's test, and estimating the association using the Cox proportional hazards regression model to adjust for potential demographic confounding factors.
The HNPCC patients who were heterozygous developed their colorectal cancer 13 years earlier than HNPCC patients who were homozygous for the wild-type allele.
Combining knowledge of an individual's p53 genotype with information on other genetic and environmental risk factors may improve risk estimates and help to identify individuals who are genetically susceptible to developing HNPCC at an earlier age.
遗传性非息肉病性结直肠癌(HNPCC)是一种常染色体显性遗传的家族性恶性肿瘤综合征。最常观察到的是结直肠癌和子宫内膜癌。该综合征主要由DNA错配修复基因的种系突变引起。p53基因第72密码子处常见的G到C多态性与肺癌、鼻咽癌、口腔癌、前列腺癌和乳腺癌的风险增加有关,可能是结直肠癌遗传易感性的一个标志物。我们研究了这种p53多态性对HNPCC发病年龄的影响。
我们确定了92名白种人错配修复突变携带者的p53基因型,其中47人患有结直肠癌。通过单链构象多态性分析对受试者进行基因分型。我们通过比较Kaplan-Meier生存曲线、使用对数秩检验和Wilcoxon检验评估曲线的同质性以及使用Cox比例风险回归模型估计关联以调整潜在的人口统计学混杂因素,来测试发病年龄与p53基因型之间的关联。
杂合的HNPCC患者患结直肠癌的时间比野生型等位基因纯合的HNPCC患者早13年。
将个体的p53基因型知识与其他遗传和环境风险因素的信息相结合,可能会改善风险估计,并有助于识别在较早年龄对发生HNPCC具有遗传易感性的个体。