Cremers Ruben G, Galesloot Tessel E, Aben Katja K, van Oort Inge M, Vasen Hans F, Vermeulen Sita H, Kiemeney Lambertus A
Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands; Department of Urology, Radboud university medical center, Nijmegen, The Netherlands; The Netherlands Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands.
Prostate. 2015 Apr 1;75(5):474-83. doi: 10.1002/pros.22933. Epub 2015 Jan 5.
More than 70 single nucleotide polymorphisms (SNPs) have been reported to be associated with prostate cancer (PC) risk; these were mainly identified in the general population with predominantly sporadic PC (SPC). Previous studies have suggested similar associations between a selection of these SNPs and hereditary PC (HPC). Our aim was to evaluate the effect of all known PC risk SNPs and their discriminative value for SPC and HPC.
Seventy-four PC susceptibility SNPs (reported in literature up to June 2014) were genotyped in a population-based series of 620 SPC patients, 312 HPC patients from the national Dutch registry and 1819 population-based referents. Association analyses were performed using logistic regression, focusing on directional consistency of the odds ratios (ORs) with those in the original reports, that is, whether the OR was in the same direction as in the original report. Discriminative performance was evaluated by a genetic risk score used in logistic regression and receiver operating characteristic (ROC) curve analyses.
Directional consistency was seen for 62 SNPs in SPC and 64 SNPs in HPC, 56 of which overlapped. ORs were mostly higher for HPC with 22 ORs >1.25 versus 5 for SPC. Discriminative performance was better for HPC with an area under the ROC curve of 0.73 versus 0.64 for SPC.
A large overlap was found for the associations between low-penetrance susceptibility SNPs and SPC and HPC, suggesting a similarity in genetic etiology. This warrants a reconsideration of "HPC" and a restrictive policy toward prostate-specific antigen testing in men with a positive family history. Genetic risk scores might be used for PC risk stratification on the population level.
据报道,超过70个单核苷酸多态性(SNP)与前列腺癌(PC)风险相关;这些主要是在以散发性PC(SPC)为主的普通人群中鉴定出来的。先前的研究表明,这些SNP中的一部分与遗传性PC(HPC)之间存在类似的关联。我们的目的是评估所有已知的PC风险SNP的作用及其对SPC和HPC的鉴别价值。
在一个基于人群的队列中,对620例SPC患者、来自荷兰国家登记处的312例HPC患者以及1819例基于人群的对照者进行了74个PC易感性SNP(截至2014年6月文献报道的)基因分型。使用逻辑回归进行关联分析,重点关注比值比(OR)与原始报告中的方向一致性,即OR是否与原始报告中的方向相同。通过逻辑回归中使用的遗传风险评分和受试者工作特征(ROC)曲线分析来评估鉴别性能。
SPC中有62个SNP和HPC中有64个SNP观察到方向一致性,其中56个重叠。HPC的OR大多更高,有22个OR>1.25,而SPC为5个。HPC的鉴别性能更好,ROC曲线下面积为0.73,而SPC为0.64。
在低 penetrance 易感性SNP与SPC和HPC之间的关联中发现了很大的重叠,这表明遗传病因学上的相似性。这值得重新考虑“HPC”以及对有阳性家族史男性进行前列腺特异性抗原检测的限制性政策。遗传风险评分可用于人群水平的PC风险分层。