Pande Mala, Amos Christopher I, Osterwisch Daniel R, Chen Jinyun, Lynch Patrick M, Broaddus Russell, Frazier Marsha L
Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Sep;17(9):2393-401. doi: 10.1158/1055-9965.EPI-08-0326.
Individuals with Lynch syndrome are predisposed to cancer due to an inherited DNA mismatch repair gene mutation. However, there is significant variability observed in disease expression likely due to the influence of other environmental, lifestyle, or genetic factors. Polymorphisms in genes encoding xenobiotic-metabolizing enzymes may modify cancer risk by influencing the metabolism and clearance of potential carcinogens from the body. In this retrospective analysis, we examined key candidate gene polymorphisms in CYP1A1, EPHX1, GSTT1, GSTM1, and GSTP1 as modifiers of age at onset of colorectal cancer among 257 individuals with Lynch syndrome. We found that subjects heterozygous for CYP1A1 I462V (c.1384A>G) developed colorectal cancer 4 years earlier than those with the homozygous wild-type genotype (median ages, 39 and 43 years, respectively; log-rank test P = 0.018). Furthermore, being heterozygous for the CYP1A1 polymorphisms, I462V and Msp1 (g.6235T>C), was associated with an increased risk for developing colorectal cancer [adjusted hazard ratio for AG relative to AA, 1.78; 95% confidence interval, 1.16-2.74; P = 0.008; hazard ratio for TC relative to TT, 1.53; 95% confidence interval, 1.06-2.22; P = 0.02]. Because homozygous variants for both CYP1A1 polymorphisms were rare, risk estimates were imprecise. None of the other gene polymorphisms examined were associated with an earlier onset age for colorectal cancer. Our results suggest that the I462V and Msp1 polymorphisms in CYP1A1 may be an additional susceptibility factor for disease expression in Lynch syndrome because they modify the age of colorectal cancer onset by up to 4 years.
林奇综合征患者由于遗传性DNA错配修复基因突变而易患癌症。然而,由于其他环境、生活方式或遗传因素的影响,疾病表现存在显著差异。编码外源性代谢酶的基因多态性可能通过影响体内潜在致癌物的代谢和清除来改变癌症风险。在这项回顾性分析中,我们检测了257例林奇综合征患者中CYP1A1、EPHX1、GSTT1、GSTM1和GSTP1基因的关键候选基因多态性,作为结直肠癌发病年龄的调节因素。我们发现,CYP1A1 I462V(c.1384A>G)杂合子患者患结直肠癌的时间比纯合野生型基因型患者早4年(中位年龄分别为39岁和43岁;对数秩检验P = 0.018)。此外,CYP1A1基因多态性I462V和Msp1(g.6235T>C)的杂合状态与患结直肠癌的风险增加相关[AG相对于AA的调整后风险比为1.78;95%置信区间为1.16 - 2.74;P = 0.008;TC相对于TT的风险比为1.53;95%置信区间为1.06 - 2.22;P = 0.02]。由于这两种CYP1A1基因多态性的纯合变异很少见,风险估计不准确。所检测的其他基因多态性均与结直肠癌的发病年龄提前无关。我们的结果表明,CYP1A1基因中的I462V和Msp1多态性可能是林奇综合征疾病表现的另一个易感因素,因为它们可使结直肠癌发病年龄提前多达4年。