Helfand Brian T, Chen Haitao, Fantus Richard J, Conran Carly A, Brendler Charles B, Zheng Siquan Lilly, Walsh Patrick C, Isaacs William B, Xu Jianfeng
Division of Urology, John and Carol Walter for Urologic Health, NorthShore University HealthSystem, Evanston, Illinois.
School of Public Health, Fudan University, Center for Genomic Translational Medicine and Prevention, Shanghai, P.R. China.
Prostate. 2018 Jun 19. doi: 10.1002/pros.23664.
Family history assigns equivalent risk to all relatives based upon the degree of relationship. Recent genetic studies have identified single nucleotide polymorphisms (SNPs) that can be used to calculate a genetic risk score (GRS) to determine prostate cancer (PCa) risk. We sought to determine whether GRS can stratify PCa risk among individuals in families considered to be at higher risk due their family history of PCa.
Family members with hereditary PCa were recruited and genotyped for 17 SNPs associated with PCa. A GRS was calculated for all subjects. Analyses compared the distribution of GRS values among affected and unaffected family members of varying relationship degrees.
Data was available for 789 family members of probands including 552 affected and 237 unaffected relatives. Median GRSs were higher among first-degree relatives compared to second- and third-degree relatives. In addition, GRS values among affected first- and second-degree relatives were significantly higher than unaffected relatives (P = 0.042 and P = 0.016, respectively). Multivariate analysis including GRS and degree of relationship demonstrated that GRS was a significant and independent predictor of PCa (OR 1.52, 95%CI 1.15-2.01).
GRS is an easy-to-interpret, objective measure that can be used to assess differences in PCa risk among family members of affected men. GRS allows for further differentiation among family members, providing better risk assessment. While prospective validation studies are required, this information can help guide relatives in regards to the time of initiation and frequency of PCa screening.
家族史根据亲属关系程度赋予所有亲属同等风险。近期的基因研究已鉴定出可用于计算遗传风险评分(GRS)以确定前列腺癌(PCa)风险的单核苷酸多态性(SNP)。我们试图确定GRS是否能在因前列腺癌家族史而被认为风险较高的家族个体中对PCa风险进行分层。
招募患有遗传性PCa的家庭成员,并对与PCa相关的17个SNP进行基因分型。为所有受试者计算GRS。分析比较了不同关系程度的患病和未患病家庭成员中GRS值的分布。
有789名先证者家庭成员的数据,包括552名患病亲属和237名未患病亲属。与二级和三级亲属相比,一级亲属的GRS中位数更高。此外,患病的一级和二级亲属的GRS值显著高于未患病亲属(分别为P = 0.042和P = 0.016)。包括GRS和亲属关系程度的多变量分析表明,GRS是PCa的显著且独立预测因子(OR 1.52,95%CI 1.15 - 2.01)。
GRS是一种易于解释的客观测量方法,可用于评估患病男性家庭成员中PCa风险的差异。GRS能够在家庭成员之间进行进一步区分,提供更好的风险评估。虽然需要前瞻性验证研究,但这些信息有助于指导亲属关于PCa筛查的起始时间和频率。