German Cancer Research Center, Heidelberg, Germany.
J Clin Oncol. 2011 May 1;29(13):1722-7. doi: 10.1200/JCO.2010.31.8873. Epub 2011 Mar 21.
Increased coagulation has been associated with cancer onset and progression. Mainly small studies have addressed the association between clotting factor gene polymorphisms and the onset of colorectal cancer. We examined the association between six well-known clotting factor gene polymorphisms and colorectal cancer risk in a large case-control study.
Factor V Leiden (rs6025), prothrombin G20210A (rs1799963), PAI-1 4G/5G (rs1799889), MTHFR 677C>T (rs1801133), fibrinogen gamma 10034C>T (rs2066865), and factor XIII Val34Leu (rs5985) were genotyped in 1,801 patients with colorectal cancer and 1,853 healthy controls from a large German population-based study. The risk of colorectal cancer associated with gene variants was determined by calculating odds ratios (ORs) and their 95% CIs using logistic regression.
Homozygous carriers of the prothrombotic factor V Leiden polymorphism showed a 5.8-fold increased risk (95% CI, 1.69 to 19.72) for colorectal cancer compared with noncarriers. A 30% reduced risk was found for heterozygous carriers of factor V Leiden (OR = 0.68; 95% CI, 0.52 to 0.90) and prothrombin G20210A (OR = 0.69; 95% CI, 0.49 to 0.96), implying an advantage for slightly increased thrombin generation. Carriers of the antithrombotic factor XIII Val34Leu polymorphism showed a 15% reduced risk of developing colorectal cancer (OR = 0.85; 95% CI, 0.74 to 0.97) compared with noncarriers. Our results did not support an effect of PAI-1 4G/5G, MTHFR 677C>T, and fibrinogen gamma 10034C>T on colorectal cancer risk.
Our results support a role of clotting factor polymorphisms and thereby the coagulation system in the risk of colorectal cancer.
已有研究表明,凝血因子的异常升高与癌症的发生和进展相关。尽管已有部分小型研究探讨了凝血因子基因突变与结直肠癌发病风险之间的相关性,但目前尚无研究对凝血因子基因多态性与结直肠癌发病风险之间的关系进行全面分析。本研究旨在通过大型病例对照研究,探讨 6 种常见凝血因子基因多态性与结直肠癌发病风险之间的关系。
采用病例对照研究,选取 1801 例结直肠癌患者和 1853 例健康对照,对凝血因子 V Leiden(rs6025)、凝血酶原 G20210A(rs1799963)、纤溶酶原激活物抑制剂-1 4G/5G(rs1799889)、亚甲基四氢叶酸还原酶 677C>T(rs1801133)、纤维蛋白原γ链 10034C>T(rs2066865)和凝血因子 XIII Val34Leu(rs5985)的基因多态性进行检测。采用 logistic 回归计算比值比(OR)及其 95%可信区间(CI),以评估基因变异与结直肠癌发病风险之间的相关性。
与非携带者相比,凝血因子 V Leiden 纯合子携带者结直肠癌发病风险增加 5.8 倍(95%CI:1.6919.72),凝血因子 V Leiden 杂合子携带者结直肠癌发病风险降低 30%(OR=0.68;95%CI:0.520.90),凝血酶原 G20210A 杂合子携带者结直肠癌发病风险降低 31%(OR=0.69;95%CI:0.490.96),提示轻度凝血酶原生成增加可能具有保护作用。与非携带者相比,抗凝血因子 XIII Val34Leu 携带者结直肠癌发病风险降低 15%(OR=0.85;95%CI:0.740.97)。PAI-1 4G/5G、亚甲基四氢叶酸还原酶 677C>T 和纤维蛋白原γ链 10034C>T 基因多态性与结直肠癌发病风险无关。
本研究结果支持凝血因子基因突变与凝血系统在结直肠癌发病风险中的作用。