Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
Pituitary. 2010 Jun;13(2):130-7. doi: 10.1007/s11102-009-0212-0.
Pituitary tumors are prevalent in the general population, with a frequency of nearly 1 in 5. The cause of most pituitary tumors remains unknown, although a genetic contribution is recognized for some. We analyzed the Utah Population Data Base (UPDB), a resource combining a computerized genealogy of the Utah population with a statewide tumor registry, to investigate familial clustering of pituitary tumors. We analyzed the genetic relationships among 741 individuals diagnosed with benign or malignant pituitary tumors who had Utah genealogy data. To test for evidence of genetic contribution to predisposition, we compared average relatedness between all pairs of individuals with pituitary tumors with the expected relatedness in this population. We also estimated relative risks (RRs) for pituitary tumors in close and distant relatives of cases by comparing observed and expected numbers of cases among relatives. Relative risks for first- and third-degree relatives were significantly elevated (RR = 2.83 and 1.63, respectively), while relative risk for second-degree relatives was not significantly different from 1.0 (RR = 0.83). The average pairwise relatedness of pituitary tumor cases was significantly higher than expected, even when close relationships were ignored. The significantly elevated risks to relatives as well as the significant excess distant relatedness observed in cases provide strong support for a genetic contribution to predisposition to pituitary tumors. Multiple high-risk pedigrees can be identified in the UPDB, and study of such pedigrees might allow identification of the gene(s) responsible for our observations. Recognizing genetic contribution to the disease may also help with counseling family members of affected individuals.
垂体肿瘤在普通人群中较为常见,发病率接近每 5 人中有 1 人。尽管一些垂体肿瘤与遗传有关,但大多数垂体肿瘤的病因仍不清楚。我们分析了犹他州人群数据库(UPDB),该数据库将犹他州人群的计算机化家谱与全州肿瘤登记处相结合,以调查垂体肿瘤的家族聚集情况。我们分析了 741 名患有良性或恶性垂体肿瘤且具有犹他州家谱数据的个体的遗传关系。为了检验遗传因素对易感性的贡献,我们比较了所有患有垂体肿瘤的个体之间的平均相关性与该人群中的预期相关性。我们还通过比较亲属中观察到的和预期的病例数,估计了病例的近亲(一级和三级亲属)和远亲(二级亲属)中垂体肿瘤的相对风险(RR)。一级和三级亲属的相对风险显著升高(RR 分别为 2.83 和 1.63),而二级亲属的相对风险与 1.0 无显著差异(RR 为 0.83)。即使忽略了近亲关系,垂体肿瘤病例的平均成对相关性也明显高于预期。亲属中风险显著升高以及病例中观察到的明显远亲关系过剩,为易感性的遗传因素提供了强有力的支持。在 UPDB 中可以识别出多个高风险的家系,对这些家系的研究可能有助于确定导致我们观察结果的基因。认识到疾病的遗传贡献也有助于对受影响个体的家庭成员进行咨询。