Zou Yuanlin, Zhu Jicun, Song Caijuan, Li Tiandong, Wang Keyan, Shi Jianxiang, Ye Hua, Wang Peng
Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.
Henan Key Laboratory of Tumor Epidemiology and State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan Province, China.
Cancer Med. 2024 May;13(9):e7230. doi: 10.1002/cam4.7230.
This study aimed to investigate environmental factors and genetic variant loci associated with hepatocellular carcinoma (HCC) in Chinese population and construct a weighted genetic risk score (wGRS) and polygenic risk score (PRS).
A case-control study was applied to confirm the single nucleotide polymorphisms (SNPs) and environmental variables linked to HCC in the Chinese population, which had been screened by meta-analyses. wGRS and PRS were built in training sets and validation sets. Area under the curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), Akaike information criterion (AIC), and Bayesian information criterion (BIC) were applied to evaluate the performance of the models.
A total of 13 SNPs were included in both risk prediction models. Compared with wGRS, PRS had better accuracy and discrimination ability in predicting HCC risk. The AUC for PRS in combination with drinking history, cirrhosis, HBV infection, and family history of HCC in training sets and validation sets (AUC: 0.86, 95% CI: 0.84-0.89; AUC: 0.85, 95% CI: 0.81-0.89) increased at least 20% than the AUC for PRS alone (AUC: 0.63, 95% CI: 0.60-0.67; AUC: 0.65, 95% CI: 0.60-0.71).
A novel model combining PRS with alcohol history, HBV infection, cirrhosis, and family history of HCC could be applied as an effective tool for risk prediction of HCC, which could discriminate at-risk individuals for precise prevention.
本研究旨在调查中国人群中与肝细胞癌(HCC)相关的环境因素和基因变异位点,并构建加权遗传风险评分(wGRS)和多基因风险评分(PRS)。
采用病例对照研究来确认在中国人群中与HCC相关的单核苷酸多态性(SNP)和环境变量,这些已通过荟萃分析进行筛选。在训练集和验证集中构建wGRS和PRS。应用曲线下面积(AUC)、净重新分类改善(NRI)、综合鉴别改善(IDI)、赤池信息准则(AIC)和贝叶斯信息准则(BIC)来评估模型的性能。
两个风险预测模型共纳入13个SNP。与wGRS相比,PRS在预测HCC风险方面具有更好的准确性和鉴别能力。在训练集和验证集中,PRS结合饮酒史、肝硬化、乙肝病毒感染和HCC家族史的AUC(AUC:0.86,95%CI:0.84 - 0.89;AUC:0.85,95%CI:0.81 - 0.89)比单独使用PRS的AUC(AUC:0.63,95%CI:0.60 - 0.67;AUC:0.65,95%CI:0.60 - 0.71)至少提高了20%。
一种将PRS与饮酒史、乙肝病毒感染、肝硬化和HCC家族史相结合的新型模型可作为HCC风险预测的有效工具,能够鉴别出有风险的个体以便进行精准预防。