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普通人群中ATM错义突变导致的癌症风险。

Risk of cancer by ATM missense mutations in the general population.

作者信息

Dombernowsky Sarah Louise, Weischer Maren, Allin Kristine Højgaard, Bojesen Stig Egil, Tybjaerg-Hansen Anne, Nordestgaard Børge Grønne

机构信息

Department of Clinical Biochemistry, Herlev University Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark.

出版信息

J Clin Oncol. 2008 Jun 20;26(18):3057-62. doi: 10.1200/JCO.2007.14.6613.

Abstract

PURPOSE

Truncating and missense mutations in the ATM gene, which cause insufficient DNA damage surveillance, allow damaged cells to proceed into mitosis, which eventually results in increased cancer susceptibility. We tested the hypotheses that ATM Ser49Cys and ATM Ser707Pro heterozygosity increase the risk of cancer overall, of breast cancer, and of 26 other cancer subtypes in the general population.

PATIENTS AND METHODS

We genotyped 10,324 individuals from the Danish general population who were observed prospectively for 36 years, during which 2,056 developed cancer.

RESULTS

Multifactorially adjusted hazard ratios for ATM Ser49Cys heterozygotes versus noncarriers were 1.2 (95% CI, 0.9 to 1.5) for cancer overall, 0.8 (95% CI, 0.3 to 2.0) for breast cancer, 4.8 (95% CI, 2.2 to 11) for melanoma, 2.3 (95% CI, 1.1 to 5.0) for prostate cancer, and 3.4 (95% CI, 1.1 to 11) for cancer of the oral cavity/pharynx. Multifactorially adjusted hazard ratios for ATM Ser707Pro heterozygotes versus noncarriers were 0.8 (95% CI, 0.6 to 1.2) for cancer overall, 0.6 (95% CI, 0.2 to 1.6) for breast cancer, 10 (95% CI, 1.1 to 93) for thyroid/other endocrine tumors, and 2.7 (95% CI, 1.0 to 7.6) for cancer of corpus uteri.

CONCLUSION

ATM missense mutations do not increase the risk of cancer overall or of breast cancer in the general population; however, we observed in exploratory analyses that ATM missense mutations may be associated with an increased risk of other cancer subtypes. As we did multiple comparisons, some of these findings could represent chance findings rather than real phenomena.

摘要

目的

ATM基因中的截短突变和错义突变会导致DNA损伤监测不足,使受损细胞进入有丝分裂,最终导致癌症易感性增加。我们检验了以下假设:在普通人群中,ATM基因Ser49Cys和Ser707Pro杂合性会增加总体患癌风险、患乳腺癌风险以及患其他26种癌症亚型的风险。

患者与方法

我们对来自丹麦普通人群的10324人进行了基因分型,并对他们进行了为期36年的前瞻性观察,在此期间有2056人患癌。

结果

ATM基因Ser49Cys杂合子与非携带者相比,经多因素调整后的总体患癌风险比为1.2(95%置信区间,0.9至1.5),乳腺癌为0.8(95%置信区间,0.3至2.0),黑色素瘤为4.8(95%置信区间,2.2至11),前列腺癌为2.3(95%置信区间,1.1至5.0),口腔/咽癌为3.4(95%置信区间,1.1至11)。ATM基因Ser707Pro杂合子与非携带者相比,经多因素调整后的总体患癌风险比为0.8(95%置信区间,0.6至1.2),乳腺癌为0.6(95%置信区间,0.2至1.6),甲状腺/其他内分泌肿瘤为10(95%置信区间,1.1至93),子宫体癌为2.7(95%置信区间,1.0至7.6)。

结论

在普通人群中,ATM基因错义突变不会增加总体患癌风险或患乳腺癌风险;然而,我们在探索性分析中观察到,ATM基因错义突变可能与其他癌症亚型的风险增加有关。由于我们进行了多次比较,其中一些发现可能是偶然发现而非真实现象。

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