Cancer, Genetics and Immunology, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7001, Australia.
Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia.
Prostate Cancer Prostatic Dis. 2018 Jun;21(2):228-237. doi: 10.1038/s41391-017-0029-2. Epub 2018 Jan 3.
Prostate cancer (PCa) is a leading cause of mortality and genetic factors can influence tumour aggressiveness. Several germline variants have been associated with PCa-specific mortality (PCSM), but further replication evidence is needed.
Twenty-two previously identified PCSM-associated genetic variants were genotyped in seven PCa cohorts (12,082 patients; 1544 PCa deaths). For each cohort, Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for risk of PCSM associated with each variant. Data were then combined using a meta-analysis approach.
Fifteen SNPs were associated with PCSM in at least one of the seven cohorts. In the meta-analysis, after adjustment for clinicopathological factors, variants in the MGMT (rs2308327; HR 0.90; p-value = 3.5 × 10) and IL4 (rs2070874; HR 1.22; p-value = 1.1 × 10) genes were confirmed to be associated with risk of PCSM. In analyses limited to men diagnosed with local or regional stage disease, a variant in AKT1, rs2494750, was also confirmed to be associated with PCSM risk (HR 0.81; p-value = 3.6 × 10).
This meta-analysis confirms the association of three genetic variants with risk of PCSM, providing further evidence that genetic background plays a role in PCa-specific survival. While these variants alone are not sufficient as prognostic biomarkers, these results may provide insights into the biological pathways modulating tumour aggressiveness.
前列腺癌(PCa)是导致死亡的主要原因之一,遗传因素可能影响肿瘤的侵袭性。已经有一些种系变异与 PCa 特异性死亡率(PCSM)相关,但需要进一步的复制证据。
在七个前列腺癌队列(12082 名患者;1544 名前列腺癌死亡)中,对 22 个先前确定的与 PCSM 相关的遗传变异进行了基因分型。对于每个队列,使用 Cox 比例风险模型计算与每个变异相关的 PCSM 风险的风险比和 95%置信区间。然后使用荟萃分析方法合并数据。
在七个队列中的至少一个队列中,有 15 个 SNPs 与 PCSM 相关。在荟萃分析中,在校正临床病理因素后,MGMT 基因中的变异(rs2308327;HR 0.90;p 值=3.5×10)和 IL4 基因中的变异(rs2070874;HR 1.22;p 值=1.1×10)被证实与 PCSM 风险相关。在仅限于诊断为局部或区域期疾病的男性的分析中,AKT1 基因中的变异(rs2494750)也被证实与 PCSM 风险相关(HR 0.81;p 值=3.6×10)。
这项荟萃分析证实了三个遗传变异与 PCSM 风险的关联,进一步证明遗传背景在 PCa 特异性生存中起作用。虽然这些变异本身不足以作为预后生物标志物,但这些结果可能为调节肿瘤侵袭性的生物学途径提供见解。