Isaacs S D, Kiemeney L A, Baffoe-Bonnie A, Beaty T H, Walsh P C
Department of Urology, Johns Hopkins Hospital, Baltimore, MD, USA.
J Natl Cancer Inst. 1995 Jul 5;87(13):991-6. doi: 10.1093/jnci/87.13.991.
It is estimated that there will be more than 244,000 new prostate cancer cases diagnosed and that more than 40,000 men will die of this disease during 1995. Evidence exists for a hereditary predisposition to prostate cancer, but the proportion of cases attributable to the inheritance of a specific gene or genes is not large. Some hereditary cancer syndromes involve more than one tumor site, and some studies have reported a familial association between prostate cancer and other cancers. The presence of other cancers in prostate cancer families may indicate a specific type of hereditary predisposition.
We studied families that were selected because of the presence of prostate cancer to determine whether hereditary prostate cancer is associated with cancers at other sites and possibly with other heritable cancer syndromes.
Data from two distinct study populations were studied retrospectively. The first population consisted of 690 case patients undergoing radical prostatectomy who were not selected for family history of prostate cancer and 640 control subjects who were the spouses or female companions of the case patients. The second population consisted of 75 multiplex families (i.e., families with multiple cases of prostate cancer) referred because they fulfilled the criteria for hereditary prostate cancer. A comparison between case and control populations for the occurrence of 14 aggregated groups of cancer was performed. Data were analyzed using Poisson regression, and relative risks (RRs) and their 95% confidence intervals (CIs) were calculated.
Brothers and fathers of prostate cancer probands have a statistically significant higher risk of prostate cancer than the male first-degree relatives of control subjects (RR = 1.76; 95% CI = 1.28-2.43). Therefore, the risk for prostate cancer is 76% higher among first-degree relatives of prostate cancer patients compared with first-degree relatives of control subjects. This higher risk was not modified by an occurrence of breast cancer in the pedigree. Also, a statistically significant higher risk was found for tumors of the central nervous system in hereditary families (RR = 3.02; 95% CI = 1.08-8.41). Statistically significant higher risks of cancer at other major sites, such as breast, ovary, or endometrium were not observed in these families.
Even among families that were specifically selected because of the presence of prostate cancer, risks for cancer at other sites appeared not to be increased. Therefore, hereditary prostate cancer appears to be a relatively site-specific disease, and it does not seem to be a part of other hereditary cancer syndromes.
据估计，1995年将有超过24.4万例新的前列腺癌病例被诊断出来，超过4万名男性将死于这种疾病。有证据表明前列腺癌存在遗传易感性，但归因于特定一个或多个基因遗传的病例比例并不高。一些遗传性癌症综合征涉及不止一个肿瘤部位，一些研究报告了前列腺癌与其他癌症之间的家族关联。前列腺癌家族中其他癌症的存在可能表明一种特定类型的遗传易感性。
我们研究了因存在前列腺癌而被挑选出的家族，以确定遗传性前列腺癌是否与其他部位的癌症相关，以及是否可能与其他遗传性癌症综合征相关。
对来自两个不同研究人群的数据进行回顾性研究。第一组人群包括690例接受根治性前列腺切除术的病例患者，这些患者并非因前列腺癌家族史而被挑选，以及640名对照对象，他们是病例患者的配偶或女性伴侣。第二组人群包括75个多重家族（即有多个前列腺癌病例的家族），这些家族因符合遗传性前列腺癌的标准而被转诊。对病例组和对照组人群中14组汇总癌症的发生情况进行了比较。使用泊松回归分析数据，并计算相对风险（RRs）及其95%置信区间（CIs）。
前列腺癌先证者的兄弟和父亲患前列腺癌的风险在统计学上显著高于对照对象的男性一级亲属（RR = 1.76；95% CI = 1.28 - 2.43）。因此，前列腺癌患者的一级亲属患前列腺癌的风险比对照对象的一级亲属高76%。这种较高的风险不会因家系中出现乳腺癌而改变。此外，在遗传性家族中发现中枢神经系统肿瘤的风险在统计学上也显著更高（RR = 3.02；95% CI = 1.08 - 8.41）。在这些家族中未观察到其他主要部位如乳腺、卵巢或子宫内膜癌症的风险在统计学上显著升高。
即使在因存在前列腺癌而特意挑选出的家族中，其他部位患癌风险似乎并未增加。因此，遗传性前列腺癌似乎是一种相对部位特异性的疾病，而且似乎并非其他遗传性癌症综合征的一部分。
