Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; Center for Clinical Epidemiology and Biostatistics, Center for Genetics and Complex Traits, University of Pennsylvania, Philadelphia, PA.
Int J Cancer. 2013 Dec 1;133(11):2672-80. doi: 10.1002/ijc.28272. Epub 2013 Jun 14.
Smoking and diabetes, consistent risk factors for pancreatic cancer, are also factors that influence telomere length maintenance. To test whether telomere length is associated with pancreatic cancer risk, we conducted a nested case-control study in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study cohort of male smokers, aged 50-69 years at baseline. Between 1992 and 2004, 193 incident cases of pancreatic adenocarcinoma occurred (mean follow-up from blood draw: 6.3 years) among participants with whole blood samples available for telomere length assays. For these cases and 660 controls, we calculated odds ratios (OR) and 95% confidence intervals using unconditional logistic regression, adjusting for age, number of years smoked regularly, and history of diabetes mellitus. Telomere length was categorized into quartiles (shortest to longest) and analyzed as both a categorical and a continuous normal variable (reported per 0.2 unit increase in telomere length). All statistical tests were two-sided. Longer telomere length was significantly associated with increased pancreatic cancer risk (continuous OR = 1.26 95% CI = 1.09-1.46; highest quartile compared to lowest, OR = 1.57, 95% CI = 1.01-2.43, p-trend = 0.007). This association remained for subjects diagnosed within the first five years of blood draw (continuous OR = 1.46, 95% CI = 1.19-1.79 highest quartile OR = 2.92, 95% CI = 1.47-5.77, p-trend = 0.002), but not those diagnosed greater than five years after blood draw (continuous OR = 1.03, 95% CI = 0.85-1.22; highest quartile OR = 1.04, 95% CI = 0.60-1.79). This is the first prospective study to suggest an association between longer blood leukocyte telomere length and increased pancreatic cancer risk.
吸烟和糖尿病是胰腺癌的一致危险因素，也是影响端粒长度维持的因素。为了测试端粒长度是否与胰腺癌风险相关，我们在基线时年龄在 50-69 岁的男性吸烟者的 Alpha-生育酚、β-胡萝卜素癌症预防（ATBC）研究队列中进行了一项巢式病例对照研究。在有全血样本可用于端粒长度检测的参与者中，1992 年至 2004 年间发生了 193 例胰腺腺癌病例（从采血到随访的平均时间为 6.3 年）。对于这些病例和 660 名对照者，我们使用非条件逻辑回归计算了比值比（OR）和 95%置信区间，调整了年龄、定期吸烟的年数和糖尿病病史。端粒长度分为四组（最短到最长），并作为分类和连续正态变量进行分析（报告每增加 0.2 个端粒长度单位）。所有统计检验均为双侧。较长的端粒长度与胰腺癌风险增加显著相关（连续 OR = 1.26，95%CI = 1.09-1.46；与最低组相比，最高组 OR = 1.57，95%CI = 1.01-2.43，p 趋势=0.007）。这种关联在采血后五年内诊断的患者中仍然存在（连续 OR = 1.46，95%CI = 1.19-1.79；最高组 OR = 2.92，95%CI = 1.47-5.77，p 趋势=0.002），但在采血五年后诊断的患者中不存在（连续 OR = 1.03，95%CI = 0.85-1.22；最高组 OR = 1.04，95%CI = 0.60-1.79）。这是第一项前瞻性研究表明，较长的白细胞端粒长度与胰腺癌风险增加之间存在关联。
