Division of Medical Oncology, ASL-1 Imperiese, Italy.
Acta Oncol. 2011 Jan;50(1):14-24. doi: 10.3109/0284186X.2010.521191. Epub 2010 Sep 27.
family history of prostate cancer is a risk factor for prostate cancer occurrence. Differently from other neoplasms no major predisposing gene has been identified.
this review article presents the controversial results of studies about the prognostic and predictive role of family history in prostate cancer, reports the discovered predisposing genes, and biologic and pathologic findings.
mortality from PC remains a significant health care problem, but no trial investigated if it changed in presence of positive family history. The largest family study yet published concluded that men with family history are diagnosed and die at earlier ages than men without it. However, it failed to stress the prognostic value of family history. Genome-wide association studies of prostate cancer have identified a number of genetic variants at different loci in different populations. Prostate neoplasms of patients with positive family history exhibit a different pattern of expression of genes related with estrogen and androgen metabolism within the tumor. High-penetrance and low-penetrance genes in diagnosis and prognosis of prostate cancer, difficulties to define a classification and to quantify relative risks of single genes, documented gene-environment interactions are discussed.
family history stands for both shared genetic and environmental factors and their interaction. The availability of prostate-specific antigen test could explain partly the high familial risk, among brothers or shortly after the diagnosis of prostate cancer. Polymorphisms in genes associated with prostate cancer probably represent the most part of familial prostate cancer burden. An increasing knowledge of disregulated cellular pathways of lethal prostate cancer could define which of all genetic alterations have a role in defining new preventive and therapeutic strategies.
家族前列腺癌病史是前列腺癌发生的一个风险因素。与其他肿瘤不同，尚未发现主要的易感基因。
本文综述了家族史在前列腺癌中的预后和预测作用的研究中存在争议的结果，报告了已发现的易感基因以及生物学和病理学发现。
前列腺癌的死亡率仍然是一个重大的医疗保健问题，但没有研究调查在家族史阳性的情况下是否发生了变化。迄今为止发表的最大规模的家族研究得出的结论是，有家族史的男性比没有家族史的男性更早被诊断和死亡。然而，它未能强调家族史的预后价值。前列腺癌的全基因组关联研究已经在不同人群的不同位置鉴定出了许多与雌激素和雄激素代谢相关的基因中的遗传变异。具有阳性家族史的前列腺肿瘤在肿瘤内表现出与雌激素和雄激素代谢相关的基因表达模式不同。在前列腺癌的诊断和预后中，高外显率和低外显率基因、定义分类和量化单基因相对风险的困难、有记录的基因-环境相互作用等问题进行了讨论。
家族史代表了共同的遗传和环境因素及其相互作用。前列腺特异性抗原检测的可用性可能部分解释了兄弟之间或在前列腺癌诊断后不久的高家族风险。与前列腺癌相关的基因中的多态性可能代表了家族性前列腺癌负担的大部分。对致命性前列腺癌中失调细胞通路的不断深入了解，可以确定所有遗传改变中哪些在确定新的预防和治疗策略方面具有作用。
