Doecke James D, Zhao Zhen Zhen, Stark Mitchell S, Green Adèle C, Hayward Nicholas K, Montgomery Grant W, Webb Penelope M, Whiteman David C
Division of Population Studies and Human Genetics, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Brisbane, Queensland, Australia.
Cancer Epidemiol Biomarkers Prev. 2008 Apr;17(4):1007-12. doi: 10.1158/1055-9965.EPI-08-0023.
Rates of adenocarcinoma of the esophagus (EAC) and esophagogastric junction (EGJAC) have been rising rapidly in recent decades, in contrast to the declining rates of esophageal squamous cell carcinomas (ESCC). Obesity is a major risk factor for both EAC and EGJAC, but not ESCC, and there is speculation that obesity promotes adenocarcinoma development through endocrine and related pathways. We therefore compared the prevalence of 12 single nucleotide polymorphisms (SNPs) in nine candidate genes previously implicated in obesity pathways (LEP, LEPR, ADIPOQ, POMC, PPARalpha, PPARgamma, RXRgamma, GHRL, and INSIG2) in a large Australian case-control study comprising DNA samples from 260 EAC cases, 301 EGJAC cases, 213 ESCC cases, and 1,352 population controls. No SNPs were associated with EGJAC or ESCC. Although several SNPs seemed to be associated with EAC on crude analysis [ADIPOQ (rs1501299), LEP (5'-untranslated region), PPARgamma (H447H), and GHRL (M72L)], effect sizes were modest and none of the associations was significant after correcting for multiple comparisons. Further, we found no consistent evidence that any of the genotypes were associated with risk of EAC or EGJAC within strata of body mass index (<25.0 kg/m(2), 25.0-29.9 kg/m(2), >30 kg/m(2)). In conclusion, our data suggest that these SNPs do not play a major role in esophageal carcinogenesis.
近几十年来,食管腺癌(EAC)和食管胃交界腺癌(EGJAC)的发病率迅速上升,与之形成对比的是食管鳞状细胞癌(ESCC)发病率的下降。肥胖是EAC和EGJAC的主要危险因素,但不是ESCC的危险因素,有人推测肥胖通过内分泌及相关途径促进腺癌的发展。因此,在一项大型澳大利亚病例对照研究中,我们比较了9个先前涉及肥胖途径的候选基因(LEP、LEPR、ADIPOQ、POMC、PPARalpha、PPARgamma、RXRgamma、GHRL和INSIG2)中12个单核苷酸多态性(SNP)的流行情况,该研究包含来自260例EAC病例、301例EGJAC病例、213例ESCC病例和1352名人群对照的DNA样本。没有SNP与EGJAC或ESCC相关。尽管在粗分析中几个SNP似乎与EAC相关[ADIPOQ(rs1501299)、LEP(5'-非翻译区)、PPARgamma(H447H)和GHRL(M72L)],但效应大小适中,在进行多重比较校正后,没有一个关联是显著的。此外,我们没有发现一致的证据表明任何基因型与体重指数分层(<25.0 kg/m²、25.0 - 29.9 kg/m²、>30 kg/m²)内的EAC或EGJAC风险相关。总之,我们的数据表明这些SNP在食管癌发生过程中不发挥主要作用。