Bonassi Stefano, Norppa Hannu, Ceppi Marcello, Strömberg Ulf, Vermeulen Roel, Znaor Ariana, Cebulska-Wasilewska Antonina, Fabianova Eleonora, Fucic Alexandra, Gundy Sarolta, Hansteen Inger-Lise, Knudsen Lisbeth E, Lazutka Juozas, Rossner Pavel, Sram Radim J, Boffetta Paolo
Unit of Molecular Epidemiology, National Cancer Research Institute, Genoa, Italy.
Carcinogenesis. 2008 Jun;29(6):1178-83. doi: 10.1093/carcin/bgn075. Epub 2008 Mar 19.
Mechanistic evidence linking chromosomal aberration (CA) to early stages of cancer has been recently supported by the results of epidemiological studies that associated CA frequency in peripheral lymphocytes of healthy individuals to future cancer incidence. To overcome the limitations of single studies and to evaluate the strength of this association, a pooled analysis was carried out. The pooled database included 11 national cohorts and a total of 22 358 cancer-free individuals who underwent genetic screening with CA for biomonitoring purposes during 1965-2002 and were followed up for cancer incidence and/or mortality for an average of 10.1 years; 368 cancer deaths and 675 incident cancer cases were observed. Subjects were classified within each laboratory according to tertiles of CA frequency. The relative risk (RR) of cancer was increased for subjects in the medium [RR = 1.31, 95% confidence interval (CI) = 1.07-1.60] and in the high (RR = 1.41; 95% CI = 1.16-1.72) tertiles when compared with the low tertile. This increase was mostly driven by chromosome-type aberrations. The presence of ring chromosomes increased the RR to 2.22 (95% CI = 1.34-3.68). The strongest association was found for stomach cancer [RR(medium) = 1.17 (95% CI = 0.37-3.70), RR(high) = 3.13 (95% CI = 1.17-8.39)]. Exposure to carcinogens did not modify the effect of CA levels on overall cancer risk. These results reinforce the evidence of a link between CA frequency and cancer risk and provide novel information on the role of aberration subclass and cancer type.
将染色体畸变(CA)与癌症早期阶段联系起来的机制证据,最近得到了流行病学研究结果的支持,这些研究将健康个体外周淋巴细胞中的CA频率与未来癌症发病率相关联。为了克服单一研究的局限性并评估这种关联的强度,进行了一项汇总分析。汇总数据库包括11个国家队列,共有22358名无癌个体,他们在1965年至2002年期间因生物监测目的接受了CA基因筛查,并对癌症发病率和/或死亡率进行了平均10.1年的随访;观察到368例癌症死亡和675例新发癌症病例。根据每个实验室中CA频率的三分位数对受试者进行分类。与低三分位数相比,中等三分位数(相对风险RR = 1.31,95%置信区间CI = 1.07 - 1.60)和高三分位数(RR = 1.41;95% CI = 1.16 - 1.72)的受试者患癌症的相对风险增加。这种增加主要由染色体型畸变驱动。环状染色体的存在使RR增加到2.22(95% CI = 1.34 - 3.68)。在胃癌中发现了最强的关联[RR(中等)= 1.17(9% CI = 0.37 - 3.70),RR(高)= 3.13(95% CI = 1.17 -8.39)]。接触致癌物并未改变CA水平对总体癌症风险的影响。这些结果强化了CA频率与癌症风险之间存在联系的证据,并提供了关于畸变亚类和癌症类型作用的新信息。