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前列腺癌风险变异与疾病进展无关。

Prostate cancer risk variants are not associated with disease progression.

机构信息

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

出版信息

Prostate. 2012 Jan;72(1):30-9. doi: 10.1002/pros.21403. Epub 2011 Apr 25.

Abstract

BACKGROUND

Currently used prognostic markers are limited in their ability to accurately predict disease progression among patients with localized prostate cancer. We examined 23 reported prostate cancer susceptibility variants for association with disease progression.

METHODS

Disease progression was explored among 4,673 Swedish patients treated for clinically localized prostate cancer between 1997 and 2002. Prostate cancer progression was defined according to primary treatment as a composed event reflecting termination of deferred treatment, biochemical recurrence, local progression, or presence of distant metastasis. Association between single variants, and all variants combined, were performed in Cox regression analysis assuming both log-additive and co-dominant genetic models.

RESULTS

Three of the 23 genetic variants explored were nominally associated with prostate cancer progression; rs9364554 (P = 0.041) on chromosome 6q25 and rs10896449 (P = 0.029) on chromosome 11q13 among patients treated with curative intent; and rs4054823 (P = 0.008) on chromosome 17p12 among patients on surveillance. However, none of these associations remained statistically significant after correction for multiple testing. The combined effect of all susceptibility variants was not associated with prostate cancer progression neither among patients receiving treatment with curative intent (P = 0.14) nor among patients on surveillance (P = 0.92).

CONCLUSIONS

We observed no evidence for an association between any of 23 established prostate cancer genetic risk variants and disease progression. Accumulating evidence suggests separate genetic components for initiation and progression of prostate cancer. Future studies systematically searching for genetic risk variants associated with prostate cancer progression and prognosis are warranted.

摘要

背景

目前使用的预后标志物在预测局限性前列腺癌患者的疾病进展方面能力有限。我们研究了 23 个已报道的前列腺癌易感性变异与疾病进展的相关性。

方法

对 1997 年至 2002 年间接受局部前列腺癌治疗的 4673 名瑞典患者进行疾病进展研究。根据主要治疗方法,将前列腺癌进展定义为反映延迟治疗终止、生化复发、局部进展或远处转移的复合事件。在 Cox 回归分析中,假设使用对数加性和共显性遗传模型,对单变体和所有变体的组合与疾病进展进行关联。

结果

在探索的 23 个遗传变异体中,有 3 个具有名义相关性;在接受根治性治疗的患者中,染色体 6q25 上的 rs9364554(P = 0.041)和染色体 11q13 上的 rs10896449(P = 0.029),以及在接受监测治疗的患者中染色体 17p12 上的 rs4054823(P = 0.008)。然而,在进行多次测试校正后,这些关联均无统计学意义。所有易感性变异体的综合效应与接受根治性治疗的患者(P = 0.14)和接受监测治疗的患者(P = 0.92)的前列腺癌进展均无相关性。

结论

我们没有发现 23 个已建立的前列腺癌遗传风险变异体中的任何一个与疾病进展相关的证据。越来越多的证据表明,前列腺癌的发生和进展有不同的遗传成分。需要进一步进行系统的研究以寻找与前列腺癌进展和预后相关的遗传风险变异体。

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