Friborg Jeppe, Wohlfahrt Jan, Koch Anders, Storm Hans, Olsen Ove R, Melbye Mads
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institute, Copenhagen.
Cancer Res. 2005 Sep 15;65(18):8567-72. doi: 10.1158/0008-5472.CAN-04-4208.
Undifferentiated nasopharyngeal carcinoma is a result of environmental factors, in particular EBV infection, affecting genetically susceptible individuals. The familial risk of nasopharyngeal carcinoma is among the highest of any malignancy. Whether this susceptibility is restricted to nasopharyngeal carcinoma is unknown as information on the risk of other cancers in relatives is limited. We did a population-based study of the cancer incidence in nasopharyngeal carcinoma families in Greenland, a nasopharyngeal carcinoma-endemic area. Using population-based registers, a cohort of all persons born in Greenland was followed from 1973 to 2002. In this cohort, 134 individuals developed nasopharyngeal carcinoma and their relatives were identified through registers and interviews. Subsequently, the occurrence of cancer was determined by linkage to the population-based cancer register and the risk of cancer in nasopharyngeal carcinoma relatives and nonrelatives compared by relative risks. Among 766 first-degree relatives, the relative risk of nasopharyngeal carcinoma following the family index case was 8.0 [95% confidence interval (95% CI), 4.1-14.0]. Sex and age of the relative or the index case had no modifying effect on the familial risk of nasopharyngeal carcinoma. The relative risks of carcinoma of the salivary glands, 8.4 (95% CI, 2.7-19.5), and uterine cervix, 2.2 (95% CI, 1.1-3.9), were also significantly increased. In families with multiple cases of nasopharyngeal carcinoma, the risk of other cancers than nasopharyngeal carcinoma was further increased. These results indicate that the increased risk of cancer in nasopharyngeal carcinoma families is not restricted to nasopharyngeal carcinoma, but extends to the virally associated cancers of the salivary glands and cervical uteri.
未分化鼻咽癌是环境因素，特别是EB病毒感染，影响遗传易感个体的结果。鼻咽癌的家族风险在所有恶性肿瘤中是最高的之一。由于关于亲属中其他癌症风险的信息有限，这种易感性是否仅限于鼻咽癌尚不清楚。我们在格陵兰岛（一个鼻咽癌高发地区）对鼻咽癌家族的癌症发病率进行了一项基于人群的研究。利用基于人群的登记册，对1973年至2002年在格陵兰岛出生的所有人组成的队列进行了随访。在这个队列中，134人患了鼻咽癌，他们的亲属通过登记册和访谈得以确定。随后，通过与基于人群的癌症登记册进行关联来确定癌症的发生情况，并通过相对风险比较鼻咽癌亲属和非亲属患癌症的风险。在766名一级亲属中，家族索引病例之后患鼻咽癌的相对风险为8.0[95%置信区间（95%CI），4.1 - 14.0]。亲属或索引病例的性别和年龄对鼻咽癌的家族风险没有调节作用。唾液腺癌的相对风险为8.4（95%CI，2.7 - 19.5），子宫颈癌的相对风险为2.2（95%CI，1.1 - 3.9），也显著增加。在有多例鼻咽癌的家族中，除鼻咽癌外其他癌症的风险进一步增加。这些结果表明，鼻咽癌家族中患癌风险的增加并不局限于鼻咽癌，而是扩展到与病毒相关的唾液腺癌和子宫颈癌。
