Spitz M R, Fueger J J, Halabi S, Schantz S P, Sample D, Hsu T C
Department of Epidemiology, University of Texas, M.D. Anderson Cancer Center, Houston 77030.
Cancer Epidemiol Biomarkers Prev. 1993 Jul-Aug;2(4):329-33.
Variability in DNA repair capability may be a determinant of interindividual difference in susceptibility to carcinogenic exposures. A cytogenetic assay which quantifies chromosomal breakage induced by in vitro exposure to a clastogen provides an indirect measure of repair. We report the results of a case-control study of upper aerodigestive tract cancers assessing differences in mutagen sensitivity based on this assay. There were 108 cases with previously untreated squamous cell cancers and 108 age and sex frequency-matched controls selected from blood donors to The University of Texas M. D. Anderson Cancer Center. Sixty-nine% of the cases, compared with 44% of the controls, were classified as mutagen sensitive (breaks per cell > or = 0.8). On multivariate analysis, mutagen sensitivity [odds ratio (OR), 2.5], heavy cigarette smoking (OR, 4.8), and heavy alcohol consumption (OR, 3.1) were associated with significantly increased risk. Stratified analyses showed that the combined effects of cigarette smoking (OR, 8.1) and mutagen sensitivity (OR, 3.2) were suggestive of a multiplicative effect (OR, 23.0). The combined estimate for alcohol use (OR, 3.0) and mutagen sensitivity (OR, 3.0) was 5.8. These data confirm those of a previously published preliminary study of upper aerodigestive cancers and underscore the importance of considering interindividual susceptibility in cancer risk characterization, even for those cancers with well quantified exposures.
DNA修复能力的变异性可能是个体对致癌暴露易感性存在差异的一个决定因素。一种细胞遗传学检测方法，通过体外暴露于断裂剂后对染色体断裂进行定量，可间接测量修复能力。我们报告了一项关于上呼吸道消化道癌症的病例对照研究结果，该研究基于此检测方法评估诱变敏感性的差异。研究选取了108例未经治疗的鳞状细胞癌患者作为病例组，以及108例年龄和性别频率匹配的对照组，对照组从德克萨斯大学MD安德森癌症中心的献血者中选取。69%的病例被归类为诱变敏感（每细胞断裂数≥0.8），而对照组这一比例为44%。多因素分析显示，诱变敏感性（比值比[OR]，2.5）、大量吸烟（OR，4.8）和大量饮酒（OR，3.1）与风险显著增加相关。分层分析表明，吸烟（OR，8.1）和诱变敏感性（OR，3.2）的联合作用提示存在相乘效应（OR，23.0）。饮酒（OR，3.0）和诱变敏感性（OR，3.0）的联合估计值为5.8。这些数据证实了先前发表的关于上呼吸道消化道癌症初步研究的数据，并强调了在癌症风险特征描述中考虑个体易感性的重要性，即使对于那些暴露量已得到充分量化的癌症也是如此。
