Department of Clinical Biochemistry, Herlev Hospital, Herlev Department of Clinical Biochemistry, Naestved Hospital, Naestved Copenhagen, Denmark.
J Intern Med. 2012 Jan;271(1):51-63. doi: 10.1111/j.1365-2796.2011.02404.x. Epub 2011 Jun 16.
Increased iron overload, whether or not owing to the presence of the haemochromatosis genotype C282Y/C282Y, may be associated with an increased risk of cancer. The aim of this study was to test the hypothesis that elevated transferrin saturation levels (as a proxy for iron overload) and haemochromatosis genotype C282Y/C282Y are associated with an increased risk of cancer.
We conducted a population-based study of 8763 individuals, of whom 1417 developed a first cancer during 15years of follow-up, and a meta-analysis. We stratified absolute 10-year risk of cancer by smoking status, an important risk factor.
In women, transferrin saturation above 60% versus below 50% was associated with a hazard ratio of 3.6 (95% confidence interval (CI): 2.0-6.5; P<0.001) for any cancer; risk of liver cancer was increased in both women and men. In women, the corresponding absolute 10-year risk of any cancer was 34% and 30% in smokers and nonsmokers, respectively. In men, haemochromatosis genotype C282Y/C282Y versus wild type/wild type was associated with a hazard ratio of 3.7 (95% CI: 1.2-12; P=0.01) for any cancer, with a similar trend in women. In men, the corresponding absolute 10-year risk of cancer was 39% and 27% in smokers and nonsmokers, respectively. Other haemochromatosis genotypes were not associated with increased risk of cancer in women or men. From the meta-analysis, the odds ratio of any cancer for transferrin saturation ≥60% versus a reference group was 1.5 (95% CI: 1.2-1.8) for women and men combined.
We have demonstrated that elevated transferrin saturation levels in women and haemochromatosis genotype C282Y/C282Y in men are associated with increased risk of cancer. Thus, our results support the implementation of cancer screening programmes in patients with iron overload or with C282Y/C282Y.
铁过载的增加，无论是否由于血色病基因型 C282Y/C282Y 的存在，都可能与癌症风险的增加有关。本研究旨在检验这样一个假设，即转铁蛋白饱和度（作为铁过载的替代指标）升高和血色病基因型 C282Y/C282Y 与癌症风险增加有关。
我们对 8763 名个体进行了一项基于人群的研究，其中 1417 人在 15 年的随访中患上了第一种癌症，并进行了荟萃分析。我们按吸烟状况对绝对 10 年癌症风险进行分层，因为吸烟是一个重要的危险因素。
在女性中，转铁蛋白饱和度高于 60%与低于 50%相比，任何癌症的风险比为 3.6（95%置信区间：2.0-6.5；P<0.001）；在女性和男性中，肝癌风险均增加。在女性中，吸烟者和不吸烟者的相应绝对 10 年任何癌症风险分别为 34%和 30%。在男性中，血色病基因型 C282Y/C282Y 与野生型/野生型相比，任何癌症的风险比为 3.7（95%置信区间：1.2-12；P=0.01），女性也有类似的趋势。在男性中，吸烟者和不吸烟者的相应绝对 10 年癌症风险分别为 39%和 27%。其他血色病基因型与女性或男性癌症风险的增加无关。从荟萃分析来看，转铁蛋白饱和度≥60%与参考组相比，任何癌症的比值比为 1.5（95%置信区间：1.2-1.8），女性和男性合并。
我们已经证明，女性转铁蛋白饱和度升高和男性血色病基因型 C282Y/C282Y 与癌症风险增加有关。因此，我们的结果支持在铁过载或 C282Y/C282Y 的患者中实施癌症筛查计划。
