Perera F P, Santella R M, Brandt-Rauf P, Kahn S, Jiang W, Tang D L, Mayer J
Columbia University School of Public Health, New York, New York 10032.
Princess Takamatsu Symp. 1990;21:339-50.
Risk of cancer is determined by the complex interaction between "environmental" exposures and genetic and nutritional factors that modulate response to carcinogenic insults. Here, the term "environmental" encompasses lifestyle, occupation, and the ambient environment. As a promising approach in cancer prevention, a number of biologic markers are currently being evaluated in terms of their ability to identify harmful exposures and populations at risk in time to effectively intervene. These biomarkers are reflective of the molecular dose or early effect of carcinogens (such as DNA or protein adducts, gene or chromosomal alterations and oncogene activation) or they provide information on potential susceptibility (such as the genetically or nutritionally determined handling of carcinogens). Techniques as diverse as immunoassays, 32P-postlabelling and gas chromatography-mass spectroscopy (GC/MS) are being deployed to measure DNA and protein adducts in cells and tissues from persons with occupational, community or lifestyle-related exposure to chemical carcinogens. Signal changes in target oncogenes and tumor suppressor genes are also being investigated in heavily exposed, "healthy" populations and in lung cancer cases and controls using current molecular biologic techniques. Inherited predisposition to lung cancer is being evaluated through such assays as aryl hydrocarbon hydroxylase (AHH), glutathione activity and restriction fragment length polymorphism. A review of recent studies using a panoply of biomarkers provides a departure point for recommendations for future, integrated molecular epidemiologic studies of cancer.
癌症风险由“环境”暴露与调节对致癌损伤反应的遗传和营养因素之间的复杂相互作用决定。在此，“环境”一词涵盖生活方式、职业和周围环境。作为癌症预防中一种有前景的方法，目前正在根据其及时识别有害暴露和高危人群以有效干预的能力，对一些生物标志物进行评估。这些生物标志物反映致癌物的分子剂量或早期效应（如DNA或蛋白质加合物、基因或染色体改变以及癌基因激活），或者它们提供有关潜在易感性的信息（如遗传或营养决定的致癌物处理方式）。免疫测定、32P后标记和气相色谱 - 质谱联用（GC/MS）等多种技术正被用于测量职业、社区或生活方式相关化学致癌物暴露人群的细胞和组织中的DNA和蛋白质加合物。还在使用当前分子生物学技术，对暴露严重的“健康”人群以及肺癌病例和对照中的靶癌基因和肿瘤抑制基因的信号变化进行研究。通过芳烃羟化酶（AHH）、谷胱甘肽活性和限制性片段长度多态性等测定来评估肺癌的遗传易感性。对近期使用大量生物标志物的研究进行综述，为未来癌症综合分子流行病学研究的建议提供了一个出发点。
