Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY 10029, USA.
Radiother Oncol. 2013 Jun;107(3):372-6. doi: 10.1016/j.radonc.2013.05.001. Epub 2013 May 26.
Rectal bleeding can occur following radiotherapy for prostate cancer and negatively impacts quality of life for cancer survivors. Treatment and clinical factors do not fully predict rectal bleeding, and genetic factors may be important.
A genome-wide association study (GWAS) was performed to identify SNPs associated with the development of late rectal bleeding following radiotherapy for prostate cancer. Logistic regression was used to test the association between 614,453 SNPs and rectal bleeding in a discovery cohort (79 cases, 289 controls), and top-ranking SNPs were tested in a replication cohort (108 cases, 673 controls) from four independent sites.
rs7120482 and rs17630638, which tag a single locus on chromosome 11q14.3, reached genome-wide significance for association with rectal bleeding (combined p-values 5.4×10(-8) and 6.9×10(-7) respectively). Several other SNPs had p-values trending toward genome-wide significance, and a polygenic risk score including these SNPs shows a strong rank-correlation with rectal bleeding (Sommers' d=5.0×10(-12) in the replication cohort).
This GWAS identified novel genetic markers of rectal bleeding following prostate radiotherapy. These findings could lead to the development of a predictive assay to identify patients at risk for this adverse treatment outcome so that dose or treatment modality could be modified.
直肠癌出血可能发生于前列腺癌放射治疗后,会对癌症幸存者的生活质量产生负面影响。治疗和临床因素并不能完全预测直肠出血,遗传因素可能很重要。
进行了一项全基因组关联研究(GWAS),以鉴定与前列腺癌放射治疗后晚期直肠出血发展相关的 SNP。使用逻辑回归在发现队列(79 例病例,289 例对照)中测试了 614453 个 SNP 与直肠出血之间的关联,并用来自四个独立站点的 108 例病例和 673 例对照的复制队列测试了排名最高的 SNP。
rs7120482 和 rs17630638 标记了 11q14.3 染色体上的单个位点,与直肠出血的关联达到了全基因组显著水平(联合 p 值分别为 5.4×10(-8) 和 6.9×10(-7))。其他几个 SNP 的 p 值也有接近全基因组显著的趋势,包含这些 SNP 的多基因风险评分与直肠出血有很强的等级相关性(复制队列中的 Sommers' d=5.0×10(-12))。
本 GWAS 鉴定了前列腺放射治疗后直肠出血的新遗传标记物。这些发现可能导致开发出一种预测性检测方法,以识别有这种不良治疗结果风险的患者,从而可以调整剂量或治疗方式。