Medical Scientist Training Program, Duke University, Durham, NC, USA.
Department of Pediatrics, Children's Health and Discovery Institute, Duke University, Durham, NC, USA.
Cancer Med. 2020 Nov;9(21):8216-8225. doi: 10.1002/cam4.3458. Epub 2020 Sep 17.
Neuroblastoma is the most common pediatric solid tumor. MYCN-amplification is an important negative prognostic indicator and inherited genetic contributions to risk are incompletely understood. Genetic determinants of stature increase risk of several adult and childhood cancers, but have not been studied in neuroblastoma despite elevated neuroblastoma incidence in children with congenital overgrowth syndromes.
We investigated the association between genetic determinants of height and neuroblastoma risk in 1538 neuroblastoma cases, stratified by MYCN-amplification status, and compared to 3390 European-ancestry controls using polygenic scores for birth length (five variants), childhood height (six variants), and adult height (413 variants). We further examined the UK Biobank to evaluate the association of known neuroblastoma risk loci and stature.
An increase in the polygenic score for childhood stature, corresponding to a ~0.5 cm increase in pre-pubertal height, was associated with greater risk of MYCN-amplified neuroblastoma (OR = 1.14, P = .047). An increase in the polygenic score for adult stature, corresponding to a ~1.7 cm increase in adult height attainment, was associated with decreased risk of MYCN-amplified neuroblastoma (OR = 0.87, P = .047). These associations persisted in case-case analyses comparing MYCN-amplified to MYCN-unamplified neuroblastoma. No polygenic height scores were associated with MYCN-unamplified neuroblastoma risk. Previously identified genome-wide association study hits for neuroblastoma (N = 10) were significantly enriched for association with both childhood (P = 4.0 × 10 ) and adult height (P = 8.9 × 10 ) in >250 000 UK Biobank study participants.
Genetic propensity to taller childhood height and shorter adult height were associated with MYCN-amplified neuroblastoma risk, suggesting that biological pathways affecting growth trajectories and pubertal timing may contribute to MYCN-amplified neuroblastoma etiology.
神经母细胞瘤是最常见的小儿实体瘤。MYCN 扩增是一个重要的负预后指标,而遗传因素对风险的影响尚不完全清楚。身高的遗传决定因素会增加几种成人和儿童癌症的风险,但在神经母细胞瘤中尚未得到研究,尽管先天性过度生长综合征患儿的神经母细胞瘤发病率升高。
我们通过多基因评分研究了身高遗传决定因素与 1538 例神经母细胞瘤病例(按 MYCN 扩增状态分层)和 3390 名欧洲血统对照者的风险之间的关联,这些评分分别用于出生长度(5 个变异)、儿童身高(6 个变异)和成人身高(413 个变异)。我们进一步研究了英国生物银行,以评估已知的神经母细胞瘤风险位点与身高的关联。
儿童身高多基因评分的增加,相当于青春期前身高增加约 0.5 厘米,与 MYCN 扩增型神经母细胞瘤的风险增加相关(OR=1.14,P=0.047)。成人身高多基因评分的增加,相当于成人身高增加约 1.7 厘米,与 MYCN 扩增型神经母细胞瘤的风险降低相关(OR=0.87,P=0.047)。这些关联在比较 MYCN 扩增型与 MYCN 非扩增型神经母细胞瘤的病例-病例分析中仍然存在。没有多基因身高评分与 MYCN 非扩增型神经母细胞瘤的风险相关。先前确定的神经母细胞瘤全基因组关联研究(N=10)在超过 250000 名英国生物银行研究参与者中,与儿童(P=4.0×10 )和成人身高(P=8.9×10 )显著相关。
较高的儿童身高和较短的成人身高遗传倾向与 MYCN 扩增型神经母细胞瘤的风险相关,这表明影响生长轨迹和青春期时间的生物学途径可能导致 MYCN 扩增型神经母细胞瘤的病因。