Institut für Pharmakogenetik, Universität Duisburg-Essen, Germany.
Eur J Med Res. 2010 Oct 25;15(10):422-7. doi: 10.1186/2047-783x-15-10-422.
Once metastasized, despite a variety of therapeutic options, the prognosis of patients with malignant melanoma (MM) is still poor. Therefore, the search for reliable markers to identify patients with high risk of disease progression is of high clinical importance. We have recently shown that TT genotypes of the single-nucleotide polymorphism (SNP) T393C in the gene GNAS1 are significantly associated with better outcome in a variety of carcinomas. -
In the present study we assessed whether the T393C SNP is also related to the clinical course in MM. 328 patients with MM were retrospectively genotyped and genotypes were correlated with clinical outcome. -
While the allele frequency in the MM group (fC 0.52) did not significantly differ from that of healthy blood donors, the T393C SNP was associated with tumor progression of MM. Carriers of the C-allele showed a significantly more severe tumor progression as estimated from the time period to develop metastasis (HR 2.2, 95% CI 1.1-3.2, p = 0.017). Proportions of 5-year metastasis-free intervals were 87.1% for TT genotypes and 66.0% for C-allele carriers. Moreover, multivariable Cox regression analysis including tumor stage and melanoma subtype proved the T393C polymorphism to be an independent factor for metastasis (p = 0.012). -
In summary, the GNAS1 T393C SNP represents a genetic host factor for predicting tumor progression also in patients with MM; genotyping of this SNP may contribute to better define patients who could benefit from an early individualized therapy.
尽管有多种治疗选择,转移性恶性黑色素瘤(MM)患者的预后仍然很差。因此,寻找可靠的标志物来识别疾病进展风险高的患者具有重要的临床意义。我们最近表明,GNAS1 基因中的单核苷酸多态性(SNP)T393C 的 TT 基因型与多种癌症的更好结局显著相关。
在本研究中,我们评估了 T393C SNP 是否与 MM 的临床病程也有关。回顾性地对 328 例 MM 患者进行了基因分型,并将基因型与临床结果相关联。
虽然 MM 组的等位基因频率(fC 0.52)与健康献血者无显著差异,但 T393C SNP 与 MM 的肿瘤进展有关。C 等位基因携带者的肿瘤进展明显更为严重,从发生转移的时间来估计(HR 2.2,95%CI 1.1-3.2,p = 0.017)。TT 基因型的 5 年无转移间隔比例为 87.1%,C 等位基因携带者为 66.0%。此外,包括肿瘤分期和黑色素瘤亚型在内的多变量 Cox 回归分析证明 T393C 多态性是转移的独立因素(p = 0.012)。
总之,GNAS1 T393C SNP 代表了预测 MM 患者肿瘤进展的遗传宿主因素;该 SNP 的基因分型可能有助于更好地定义可能受益于早期个体化治疗的患者。