Penney Kathryn L, Salinas Claudia A, Pomerantz Mark, Schumacher Fredrick R, Beckwith Christine A, Lee Gwo-Shu, Oh William K, Sartor Oliver, Ostrander Elaine A, Kurth Tobias, Ma Jing, Mucci Lorelei, Stanford Janet L, Kantoff Philip W, Hunter David J, Stampfer Meir J, Freedman Matthew L
Department of Epidemiology, Harvard School of Public Health, Harvard University, Cambridge, Massachusetts, USA.
Clin Cancer Res. 2009 May 1;15(9):3223-30. doi: 10.1158/1078-0432.CCR-08-2733. Epub 2009 Apr 14.
Variants at chromosomal loci 8q24 and 17q are established risk factors for prostate cancer. Many studies have confirmed the findings for risk, but few have examined aggressiveness and other clinical variables in detail. Additionally, Gleason score is typically used as a surrogate for the primary end point of prostate cancer mortality. We investigated whether the 8q24 and 17q risk variants are associated with clinical variables as well as prostate cancer mortality.
In the Physicians' Health Study (1,347 cases and 1,462 controls), the Dana-Farber Harvard Cancer Center Specialized Program of Research Excellence (Gelb Center; 3,714 cases), and the Fred Hutchinson Cancer Research Center King County Case-Control Studies (1,308 cases and 1,266 controls), we examined eight previously identified 8q24 and 17q risk variants for association with prostate cancer mortality in men of European ancestry. We considered associations with other surrogate markers of prostate cancer aggressiveness, such as Gleason score, pathologic stage, prostate-specific antigen at diagnosis, and age at diagnosis.
Six of the eight variants were confirmed as prostate cancer risk factors. Several variants were nominally associated with age at diagnosis; when totaling all alleles for single nucleotide polymorphisms significantly associated with risk, each additional allele decreased age at diagnosis by an average of 6 months in the Physicians' Health Study (P = 0.0005) and 4 months in the Dana-Farber Harvard Cancer Center Specialized Program of Research Excellence (Gelb Center) cohort (P = 0.0016). However, there were no statistically significant associations with prostate cancer mortality.
Our results suggest that the 8q24 and 17q prostate cancer risk variants may influence age at diagnosis but not disease aggressiveness.
染色体位点8q24和17q处的变异是前列腺癌已确定的风险因素。许多研究已证实了这些风险相关的研究结果,但很少有研究详细检查侵袭性及其他临床变量。此外, Gleason评分通常被用作前列腺癌死亡率这一主要终点的替代指标。我们调查了8q24和17q风险变异是否与临床变量以及前列腺癌死亡率相关。
在医师健康研究(1347例病例和1462例对照)、达纳-法伯哈佛癌症中心卓越研究专项计划(Gelb中心;3714例病例)以及弗雷德·哈钦森癌症研究中心金县病例对照研究(1308例病例和1266例对照)中,我们检测了8个先前确定的8q24和17q风险变异与欧洲血统男性前列腺癌死亡率的关联。我们还考虑了与前列腺癌侵袭性的其他替代标志物的关联,如Gleason评分、病理分期、诊断时的前列腺特异性抗原以及诊断年龄。
8个变异中的6个被确认为前列腺癌风险因素。几个变异与诊断年龄存在名义上的关联;在医师健康研究中,当将与风险显著相关的单核苷酸多态性的所有等位基因相加时,每增加一个等位基因,诊断年龄平均降低6个月(P = 0.0005),在达纳-法伯哈佛癌症中心卓越研究专项计划(Gelb中心)队列中降低4个月(P = 0.0016)。然而,与前列腺癌死亡率没有统计学上的显著关联。
我们的结果表明,8q24和17q前列腺癌风险变异可能影响诊断年龄,但不影响疾病侵袭性。