Hung Rayjean J, Moore Lee, Boffetta Paolo, Feng Bing-Jian, Toro Jorge R, Rothman Nathanial, Zaridze David, Navratilova Marie, Bencko Vladimir, Janout Vladimir, Kollarova Helena, Szeszenia-Dabrowska Neonila, Mates Dana, Chow Wong-Ho, Brennan Paul
IARC, 150 cours Albert Thomas, F-69372 Lyon Cedex 08, France.
Cancer Epidemiol Biomarkers Prev. 2007 Jun;16(6):1287-90. doi: 10.1158/1055-9965.EPI-06-0963.
An elevated familial relative risk may indicate either an important genetic component in etiology or shared environmental exposures within the family. Incidence rates of kidney cancer are particularly high in Central Europe, although no data were available on the familial aggregation or genetic background of kidney cancer in this region. We have, therefore, investigated the role of family history in first-degree relatives in a large multicenter case-control study in Central Europe. A total number of 1,097 cases of kidney cancer and 1,555 controls were recruited from 2000 to 2003 from seven centers in Czech Republic, Poland, Romania, and Russia. The risk of kidney cancer increased with the increasing number of relatives with history of any cancer [odds ratio (OR), 1.15; 95% confidence interval (95% CI), 1.00-1.31 per affected relative], and this association seemed to be more prominent among subjects with young onset (OR, 1.55; 95% CI, 1.09-2.20 per affected relative). Overall, the OR was 1.40 (95% CI, 0.71- 2.76) for the subjects who had at least one first-degree relative with kidney cancer after adjusting for tobacco smoking, body mass index, and medical history of hypertension, and this association was most apparent among subjects with affected siblings (OR, 4.09; 95% CI, 1.09-15.4). Based on the relative risk to siblings in our study population, we estimated that 80% of the kidney cancer cases are likely to occur in 20% of the population with the highest genetic risk, which indicate the importance of further investigation of genetic factors in cancer prevention for kidney cancer.
家族相对风险升高可能表明病因中存在重要的遗传成分,或者家族成员共享环境暴露因素。中欧地区肾癌的发病率特别高,尽管该地区尚无关于肾癌家族聚集性或遗传背景的数据。因此,我们在中欧一项大型多中心病例对照研究中,调查了一级亲属家族史的作用。2000年至2003年期间,从捷克共和国、波兰、罗马尼亚和俄罗斯的七个中心招募了总共1097例肾癌病例和1555名对照。肾癌风险随着有任何癌症病史的亲属数量增加而升高[比值比(OR)为1.15;95%置信区间(95%CI)为每例受影响亲属1.00 - 1.31],这种关联在发病年龄较轻的受试者中似乎更为显著(OR为1.55;95%CI为每例受影响亲属1.09 - 2.20)。总体而言,在调整吸烟、体重指数和高血压病史后,至少有一名患肾癌一级亲属的受试者的OR为1.40(95%CI为0.71 - 2.76),这种关联在有患癌兄弟姐妹的受试者中最为明显(OR为4.09;95%CI为1.09 - 15.4)。根据我们研究人群中患癌风险相对兄弟姐妹的情况,我们估计80%的肾癌病例可能发生在20%遗传风险最高的人群中,这表明进一步研究肾癌预防中的遗传因素具有重要意义。