Clinical Genetics Service andthe Cancer Biology and Genetics Program, Memorial Sloan-Kettering Cancer Center, NY, NY 10021, USA.
J Clin Oncol. 2010 Sep 20;28(27):4255-67. doi: 10.1200/JCO.2009.25.7816. Epub 2010 Jun 28.
Knowledge of the inherited risk for cancer is an important component of preventive oncology. In addition to well-established syndromes of cancer predisposition, much remains to be discovered about the genetic variation underlying susceptibility to common malignancies. Increased knowledge about the human genome and advances in genotyping technology have made possible genome-wide association studies (GWAS) of human diseases. These studies have identified many important regions of genetic variation associated with an increased risk for human traits and diseases including cancer. Understanding the principles, major findings, and limitations of GWAS is becoming increasingly important for oncologists as dissemination of genomic risk tests directly to consumers is already occurring through commercial companies. GWAS have contributed to our understanding of the genetic basis of cancer and will shed light on biologic pathways and possible new strategies for targeted prevention. To date, however, the clinical utility of GWAS-derived risk markers remains limited.
对癌症遗传风险的了解是预防肿瘤学的一个重要组成部分。除了已确立的癌症易感性综合征外,对于常见恶性肿瘤易感性的遗传变异还有很多需要发现。对人类基因组的认识不断提高,基因分型技术的进步使得对人类疾病的全基因组关联研究(GWAS)成为可能。这些研究已经确定了许多与人类特征和疾病(包括癌症)风险增加相关的重要遗传变异区域。随着基因组风险测试通过商业公司直接向消费者传播,了解 GWAS 的原则、主要发现和局限性对肿瘤学家来说变得越来越重要。GWAS 有助于我们了解癌症的遗传基础,并揭示生物学途径和可能的新靶向预防策略。然而,迄今为止,GWAS 衍生的风险标志物的临床实用性仍然有限。