McWilliams Robert R, Bamlet William R, Rabe Kari G, Olson Janet E, de Andrade Mariza, Petersen Gloria M
Department of Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Clin Gastroenterol Hepatol. 2006 Sep;4(9):1143-7. doi: 10.1016/j.cgh.2006.05.029. Epub 2006 Jul 24.
BACKGROUND & AIMS: Pancreatic adenocarcinoma has been associated with several familial cancer syndromes that also predispose to other malignancies. Younger ages of onset of pancreatic cancer (PC) have been reported in families with these syndromes.
Six hundred twenty-four consecutive patients (probands) from the Mayo Clinic Pancreatic Cancer Patient Registry who completed questionnaires were analyzed for family history of cancer and cigarette smoking. The ages at diagnosis of those probands who reported a family history (first- or second-degree relative) of PC, breast, ovarian, colorectal cancer, or melanoma were compared with those probands who did not. Multivariable regression analyses were performed with age at diagnosis as the primary outcome variable.
As expected, smokers had a younger median age of onset of PC than nonsmokers in dose-dependent fashion (P = .0003). After controlling for tobacco exposure and gender, those probands with a family history of breast (-3.23 years, P = .001), ovarian (-5.63 years, P = .005), colorectal (-3.19 years, P = .002) cancers, and melanoma (-5.75 years, P = .017) had a younger age of onset of PC than those who did not. Those with a family history of PC (-.61 years, P = .65) exhibited no difference. Probands reporting other cancers in relatives showed no difference (+.78 years, P = .49) in age of onset of PC.
A family history of cancers (breast, ovarian, colorectal, melanoma) associated with specific cancer syndromes that are known to contribute also to PC risk is associated with a younger onset of PC. A family history of PC does not appear to affect age of onset of PC.
胰腺腺癌与几种家族性癌症综合征相关,这些综合征也易引发其他恶性肿瘤。据报道,患有这些综合征的家族中胰腺癌(PC)的发病年龄较轻。
对梅奥诊所胰腺癌患者登记处连续624名完成问卷的患者(先证者)进行癌症家族史和吸烟情况分析。将报告有胰腺癌、乳腺癌、卵巢癌、结直肠癌或黑色素瘤家族史(一级或二级亲属)的先证者的诊断年龄与无家族史的先证者进行比较。以诊断年龄作为主要结局变量进行多变量回归分析。
正如预期的那样,吸烟者胰腺癌的中位发病年龄比不吸烟者年轻,且呈剂量依赖性(P = 0.0003)。在控制了烟草暴露和性别因素后,有乳腺癌家族史(-3.23岁,P = 0.001)、卵巢癌家族史(-5.63岁,P = 0.005)、结直肠癌家族史(-3.19岁,P = 0.002)和黑色素瘤家族史(-5.75岁,P = 0.017)的先证者胰腺癌发病年龄比无家族史者年轻。有胰腺癌家族史的患者(-0.61岁,P = 0.65)无差异。报告亲属患有其他癌症的先证者在胰腺癌发病年龄上无差异(+0.78岁,P = 0.49)。
与特定癌症综合征相关的癌症(乳腺癌、卵巢癌、结直肠癌、黑色素瘤)家族史,已知这些综合征也会增加患胰腺癌的风险,与胰腺癌发病年龄较轻有关。胰腺癌家族史似乎不影响胰腺癌的发病年龄。