Smith A L, Bascuñana C, Hall A, Salman A, Andrei A Z, Volenik A, Rothenmund H, Ferland D, Lamoussenery D, Kamath A S, Amre R, Caglar D, Gao Z H, Haegert D G, Kanber Y, Michel R P, Omeroglu-Altinel G, Asselah J, Bouganim N, Kavan P, Arena G, Barkun J, Chaudhury P, Gallinger S, Foulkes W D, Omeroglu A, Metrakos P, Zogopoulos G
The Research Institute of the McGill University Health Centre, Montreal, QC. ; The Goodman Cancer Research Centre, McGill University, Montreal, QC.
The Research Institute of the McGill University Health Centre, Montreal, QC. ; Hepato-Pancreato-Biliary and Transplant Surgery, McGill University Health Centre, Montreal, QC.
Curr Oncol. 2015 Apr;22(2):113-21. doi: 10.3747/co.22.2300.
Enrolling patients in studies of pancreatic ductal adenocarcinoma (pdac) is challenging because of the high fatality of the disease. We hypothesized that a prospective clinic-based study with rapid ascertainment would result in high participation rates. Using that strategy, we established the Quebec Pancreas Cancer Study (qpcs) to investigate the genetics and causes of pdac and other periampullary tumours (pats) that are also rare and underrepresented in research studies.
Patients diagnosed with pdac or pat were introduced to the study at their initial clinical encounter, with a strategy to enrol participants within 2 weeks of diagnosis. Patient self-referrals and referrals of unaffected individuals with an increased risk of pdac were also accepted. Family histories, epidemiologic and clinical data, and biospecimens were collected. Additional relatives were enrolled in families at increased genetic risk.
The first 346 completed referrals led to 306 probands being enrolled, including 190 probands affected with pdac, who represent the population focus of the qpcs. Participation rates were 88.4% for all referrals and 89.2% for pdac referrals. Family history, epidemiologic and clinical data, and biospecimens were ascertained from 91.9%, 54.6%, and 97.5% respectively of patients with pdac. Although demographics and trends in risk factors in our patients were consistent with published statistics for patients with pdac, the qpcs is enriched for families with French-Canadian ancestry (37.4%), a population with recurrent germ-line mutations in hereditary diseases.
Using rapid ascertainment, a pdac and pat research registry with high participation rates can be established. The qpcs is a valuable research resource and its enrichment with patients of French-Canadian ancestry provides a unique opportunity for studies of heredity in these diseases.
由于胰腺导管腺癌(pdac)致死率高,招募患者参与相关研究具有挑战性。我们推测,一项基于临床的前瞻性快速确诊研究将带来高参与率。采用该策略,我们设立了魁北克胰腺癌研究(qpcs),以调查pdac及其他壶腹周围肿瘤(pats)的遗传学特征和病因,这些肿瘤同样罕见且在研究中代表性不足。
确诊为pdac或pat的患者在首次临床就诊时被介绍至该研究,策略是在诊断后2周内招募参与者。患者自我推荐以及pdac风险增加的未患病个体的推荐也被接受。收集家族史、流行病学和临床数据以及生物样本。遗传风险增加的家庭中的其他亲属也被纳入研究。
最初的346份完成推荐导致306名先证者被纳入研究,其中包括190名受pdac影响的先证者,他们是qpcs的研究重点人群。所有推荐的参与率为88.4%,pdac推荐的参与率为89.2%。分别从91.9%、54.6%和97.5%的pdac患者中获取了家族史、流行病学和临床数据以及生物样本。尽管我们患者的人口统计学特征和风险因素趋势与已发表的pdac患者统计数据一致,但qpcs中法国裔加拿大血统的家庭比例较高(37.4%),这是一个遗传性疾病中常发生种系突变的人群。
通过快速确诊,可以建立一个参与率高的pdac和pat研究登记处。qpcs是一个宝贵的研究资源,其法国裔加拿大血统患者的富集为这些疾病的遗传研究提供了独特的机会。