Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2012 Mar 1;118(5):1228-35. doi: 10.1002/cncr.26398. Epub 2011 Jul 28.
Thyroid cancer incidence in the United States, particularly in women, has increased dramatically since the 1980s. Although the causes of thyroid cancer in most patients remain largely unknown, evidence suggests the existence of an inherited predisposition to development of differentiated thyroid carcinoma (DTC). Therefore, the authors explored the association between sporadic DTC and family history of cancer.
In a retrospective hospital-based case-control study of prospectively recruited subjects who completed the study questionnaire upon enrollment, unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) as estimates of the DTC risk associated with first-degree family history of cancer.
The study included 288 patients with sporadic DTC and 591 cancer-free controls. Family history of thyroid cancer in first-degree relatives was associated with increased DTC risk (adjusted OR, 4.1; 95% CI, 1.7-9.9). All DTC cases in patients with a first-degree family history of thyroid cancer were cases of papillary thyroid carcinoma (PTC) (adjusted OR, 4.6; 95% CI, 1.9-11.1). Notably, the risk of PTC was highest in subjects with a family history of thyroid cancer in siblings (OR, 7.4; 95% CI, 1.8-30.4). In addition, multifocal primary tumor was more common among PTC patients with first-degree family history of thyroid cancer than among PTC patients with no first-degree family history of thyroid cancer (68.8% vs 35.5%, P = .01).
The study suggests that family history of thyroid cancer in first-degree relatives, particularly in siblings, is associated with an increased risk of sporadic PTC.
自 20 世纪 80 年代以来,美国甲状腺癌的发病率,尤其是在女性中,急剧上升。尽管大多数患者的甲状腺癌病因仍知之甚少,但有证据表明存在分化型甲状腺癌(DTC)发生的遗传易感性。因此,作者探讨了散发性 DTC 与癌症家族史之间的关系。
在一项回顾性基于医院的病例对照研究中,前瞻性招募了完成研究问卷的受试者,采用非条件逻辑回归计算优势比(OR)和 95%置信区间(CI),作为与一级亲属癌症家族史相关的 DTC 风险的估计值。
研究纳入了 288 例散发性 DTC 患者和 591 例无癌症对照者。一级亲属甲状腺癌家族史与 DTC 风险增加相关(校正 OR,4.1;95%CI,1.7-9.9)。所有患有一级亲属甲状腺癌家族史的 DTC 患者均为甲状腺乳头状癌(PTC)(校正 OR,4.6;95%CI,1.9-11.1)。值得注意的是,在有甲状腺癌家族史的兄弟姐妹中,PTC 的风险最高(OR,7.4;95%CI,1.8-30.4)。此外,与无一级亲属甲状腺癌家族史的 PTC 患者相比,有一级亲属甲状腺癌家族史的 PTC 患者多灶性原发肿瘤更为常见(68.8% vs 35.5%,P=0.01)。
该研究表明,一级亲属,尤其是兄弟姐妹的甲状腺癌家族史与散发性 PTC 风险增加相关。