Kee F, Collins B J, Patterson C C
Department of Epidemiology and Public Health, Queen's University of Belfast.
Gut. 1991 May;32(5):513-6. doi: 10.1136/gut.32.5.513.
Familial cases of non-polyposis colorectal cancer have attracted much interest but little is known of their natural history. Using a population based study we have determined whether a positive family history of bowel cancer is an independent prognostic factor. All patients under 55 years with histologically confirmed colorectal cancer in Northern Ireland during the period 1976-8 were studied. The family history was validated in 95% of all nonpolyposis cases (n = 205). Medical history or cause of death were verified for 98% of 1811 first degree relatives. The strength of the family history was assessed using a score that compares the mortality from bowel cancer in the family against the average population mortality, taking account of family size and age structure. The family history score was not predictive of survival neither in univariate analysis or in a Cox's proportional hazards multivariate analysis controlling for age, sex, stage, site, and duration of symptoms. In conclusion, a positive family history does not independently influence prognosis in patients with bowel cancer.
家族性非息肉病性结直肠癌病例已引起广泛关注，但对其自然病史了解甚少。通过一项基于人群的研究，我们确定了肠癌家族史是否为独立的预后因素。对1976 - 1988年间北爱尔兰所有55岁以下经组织学确诊为结直肠癌的患者进行了研究。在所有非息肉病病例（n = 205）中，95%的家族史得到了验证。对1811名一级亲属中的98%核实了病史或死亡原因。家族史的强度通过一个分数来评估，该分数将家族中肠癌死亡率与一般人群死亡率进行比较，同时考虑家族规模和年龄结构。在单因素分析或在控制年龄、性别、分期、部位和症状持续时间的Cox比例风险多因素分析中，家族史分数均不能预测生存率。总之，阳性家族史并不能独立影响肠癌患者的预后。
