Saenko Vladimir A, Rogounovitch Tatiana I
Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
Endocrinol Metab (Seoul). 2018 Jun;33(2):164-174. doi: 10.3803/EnM.2018.33.2.164.
Thyroid cancer has one of the highest hereditary component among human malignancies as seen in medical epidemiology investigations, suggesting the potential meaningfulness of genetic studies. Here we review researches into genetic variations that influence the chance of developing non-familial differentiated thyroid cancer (DTC), focusing on the major findings of the genome-wide association studies (GWASs) of common single-nucleotide polymorphisms (SNPs). To date, eight GWAS have been performed, and the association of a number of SNPs have been reproduced in dozens of replication investigations across different ethnicities, including Korea and Japan. Despite the cumulative effect of the strongest SNPs demonstrates gradual increase in the risk for cancer and their association signals are statistically quite significant, the overall prediction ability for DTC appears to be very limited. Thus, genotyping of common SNPs only would be insufficient for evidence-based counseling in clinical setting at present. Further studies to include less significant and rare SNPs, non-SNP genetic information, gene-gene interactions, ethnicity, non-genetic and environmental factors, and development of more advanced computational algorithms are warranted to approach to personalized disease risk prediction and prognostication.
正如医学流行病学调查所示,甲状腺癌在人类恶性肿瘤中具有最高的遗传因素之一,这表明基因研究具有潜在的意义。在此,我们回顾了关于影响非家族性分化型甲状腺癌(DTC)发生几率的基因变异的研究,重点关注常见单核苷酸多态性(SNP)的全基因组关联研究(GWAS)的主要发现。迄今为止,已经进行了八项GWAS研究,并且许多SNP的关联在包括韩国和日本在内的不同种族的数十项重复研究中得到了再现。尽管最强SNP的累积效应显示癌症风险逐渐增加,并且它们的关联信号在统计学上非常显著,但DTC的总体预测能力似乎非常有限。因此,目前仅对常见SNP进行基因分型不足以在临床环境中进行循证咨询。有必要进行进一步的研究,包括不太显著和罕见的SNP、非SNP遗传信息、基因-基因相互作用、种族、非遗传和环境因素,以及开发更先进的计算算法,以实现个性化疾病风险预测和预后评估。