Ji Jianguang, Försti Asta, Sundquist Jan, Lenner Per, Hemminki Kari
Center for Family and Community Medicine, Karolinska Institute, Alfred Nobels alle 12, 14183 Huddinge, Sweden.
J Am Soc Nephrol. 2008 May;19(5):985-91. doi: 10.1681/ASN.2007070818. Epub 2008 Feb 6.
Having family members with cancer has been associated with increased risk for bladder and renal cell cancers, but its association with survival has not been examined. This study was an analysis of the nationwide Swedish Family-Cancer Database and revealed that survival for bladder and renal cell cancers was similar whether the cancer was familial or sporadic; however, when survival in offspring was analyzed according to the affected parents' length of survival, prognosis was concordant. Cox proportional hazard regression models revealed that for bladder cancer, the risk for death among offspring whose parents survived > or =5 yr was approximately one third that of offspring whose parents survived <5 yr, after adjustment for gender, age at diagnosis, time period of diagnosis, socioeconomic status, and geographic region (adjusted hazard ratio 0.34; 95% confidence interval 0.15 to 0.80, for overall mortality). A risk of similar magnitude was found for renal cell cancer (adjusted hazard ratio 0.38; 95% confidence interval 0.16 to 0.87, for overall mortality). These population-level findings suggest heritability of prognosis for bladder and renal cell cancers. Genetic factors likely contribute to the mechanism underlying this observation.
家庭成员患癌症与膀胱癌和肾细胞癌风险增加相关,但尚未研究其与生存率的关系。本研究对瑞典全国性家庭癌症数据库进行了分析,结果显示,无论是家族性还是散发性的膀胱癌和肾细胞癌,其生存率相似;然而,根据受影响父母的生存时长分析后代的生存率时,预后是一致的。Cox比例风险回归模型显示,对于膀胱癌,在调整性别、诊断时年龄、诊断时间段、社会经济地位和地理区域后,父母存活≥5年的后代死亡风险约为父母存活<5年的后代的三分之一(总体死亡率调整后风险比0.34;95%置信区间0.15至0.80)。肾细胞癌也发现了类似程度的风险(总体死亡率调整后风险比0.38;95%置信区间0.16至0.87)。这些人群水平的研究结果提示膀胱癌和肾细胞癌预后具有遗传性。遗传因素可能促成了这一观察结果背后的机制。