Department of Medical Oncology, Mercy Cancer Center, Ardmore, Oklahoma, USA.
Oncologist. 2013;18(5):493-500. doi: 10.1634/theoncologist.2012-0419. Epub 2013 May 1.
Several single-nucleotide polymorphisms (SNPs) associated with breast cancer risk have been identified through genome-wide association studies (GWAS). We investigated whether eight risk SNPs identified in GWAS were associated with breast cancer disease-free survival (DFS) and overall survival (OS) rates.
A cohort of 739 white women with early-stage breast cancer was genotyped for eight GWAS-identified SNPs (rs2981582, rs1219648 [FGFR2], rs3803662, rs12443621, rs8051542 [TOX3], rs999737 [RAD51L1], rs6504950 [17q23], and rs4973768 [3p24]). Relationships between SNPs and breast cancer outcomes were evaluated using Cox proportional hazard regression models. The cumulative effects of SNPs on breast cancer outcomes were assessed by computing the number of at-risk genotypes.
At a median follow-up of 121 months (range: 188-231 months) for survivors, 237 deaths (32%) and 186 breast cancer events (25%) were identified among the 739 patients. After adjusting for age, clinical stage, and treatment, rs12443621 (16q12; p = .03) and rs6504950 (17q23; p = .008) were prognostic for OS but not DFS. A higher risk for death was also found in the multivariable analysis of patients harboring three or four at-risk genotypes of the GWAS SNPs compared to patients carrying two or less at-risk genotypes (hazard ratio: 1.60, 95% confidence interval: 1.23-2.24; p = .0008).
The study results suggest that previously identified breast cancer risk susceptibility loci, rs12443621 (16q12) and rs6504950 (17q23), may influence breast cancer prognosis or comorbid conditions associated with overall survival. The precise molecular mechanisms through which these risk SNPs, as well as others that were not included in the analysis, influence clinical outcomes remain to be determined.
通过全基因组关联研究(GWAS)已经确定了几个与乳腺癌风险相关的单核苷酸多态性(SNP)。我们研究了 GWAS 中确定的八个风险 SNP 是否与乳腺癌无病生存期(DFS)和总生存期(OS)相关。
对 739 名患有早期乳腺癌的白人女性进行了 8 个 GWAS 确定的 SNP(rs2981582、rs1219648 [FGFR2]、rs3803662、rs12443621、rs8051542 [TOX3]、rs999737 [RAD51L1]、rs6504950 [17q23]和 rs4973768 [3p24])的基因分型。使用 Cox 比例风险回归模型评估 SNP 与乳腺癌结局之间的关系。通过计算危险基因型的数量来评估 SNP 对乳腺癌结局的累积影响。
在幸存者的中位随访时间为 121 个月(范围:188-231 个月)时,739 名患者中有 237 例死亡(32%)和 186 例乳腺癌事件(25%)。在校正年龄、临床分期和治疗后,rs12443621(16q12;p=.03)和 rs6504950(17q23;p=.008)与 OS 相关,但与 DFS 无关。在多变量分析中,与携带两个或更少危险基因型的患者相比,携带三个或四个 GWAS SNP 危险基因型的患者的死亡风险也更高(危险比:1.60,95%置信区间:1.23-2.24;p=0.0008)。
研究结果表明,先前确定的乳腺癌风险易感性位点 rs12443621(16q12)和 rs6504950(17q23)可能影响乳腺癌预后或与总生存期相关的合并症。这些风险 SNP 以及未纳入分析的其他 SNP 影响临床结局的确切分子机制仍有待确定。