前列腺癌家族史研究或可有效预测个体的患癌风险

  近日，来自亨茨曼癌症研究所（Huntsman Cancer Institute）的研究人员发现，观察一个男性的祖父或曾祖父（两代或三代亲戚）是否患有前列腺癌对于预测其父亲患前列腺癌的风险非常关键，一个完整的家族史疾病研究或可作为一种新型工具来确定个体是否需要进行前列腺特异性抗原（PAS）的筛查，相关研究刊登于国际杂志The Prostate上。
  研究者Lisa Cannon-Albright表示，家族史是预测前列腺癌的实质风险因素，临床医生会询问病人是否其家族中有患前列腺癌的病人，从而来确定其是否为一级亲属，进而预测个体的患癌风险。研究者对犹他州人口数据库中的数据进行了分析，该数据库包括了超过730万人谱系及医疗信息，以此研究人员就可以根据个体家族的前列腺癌历史来预测个体的患癌风险。
  文章中，研究者结合了许多不同的隐私，比如年龄、亲密度等计算了个体在有前列腺癌家族史中的相对患病风险；该研究或可帮助研究人员确定合适的个体计划来进行前列腺癌的筛查；由于家族有患病史，因此三分之二的犹他州男性患前列腺癌的风险都会增加，但是仅有少数会存在实质性的风险增加，相比无疾病家族史的个体而言，疾病家族史中10%的个体风险要高三倍，26%的个体风险要高两倍。

  Robert A. Stephenson说道，我们的研究结果对临床应用非常关键，因为目前科学界对前列腺癌筛查并无定论，因此分析和患病家族史相关的前列腺癌的风险或可帮助男性受益于靶向的疾病筛查。目前研究人员正在进行乳腺癌及肺癌的家族史风险评估研究，研究者希望通过他们的深入研究对于开发有效预防多种癌症的新型疗法带来帮助。

  最后研究者表示，如果揭示了和前列腺癌相关的遗传突变，那么利用家族史数据或或可经济、有效而且准确地进行前列腺癌风险的预测。
  （转化医学网360zhyx.com）
  以上为转化医学网原创翻译整理，如需转载，请联系 info@360zhyx.com
转化医学网推荐的原文摘要：

Prostate cancer risk prediction based on complete prostate cancer family history
The Prostate DOI: 10.1002/pros.22925
Frederick Albright1, Robert A. Stephenson2,3,4, Neeraj Agarwal4,5, Craig C. Teerlink6, William T. Lowrance2,3,4, James M. Farnham6 andLisa A. Cannon Albright3,4,6,*
BACKGROUND
Prostate cancer (PC) relative risks (RRs) are typically estimated based on status of close relatives or presence of any affected relatives. This study provides RR estimates using extensive and specific PC family history.
METHODS
A retrospective population-based study was undertaken to estimate RRs for PC based on complete family history of PC. A total of 635,443 males, all with ancestral genealogy data, were analyzed. RRs for PC were determined based upon PC rates estimated from males with no PC family history (without PC in first, second, or third degree relatives). RRs were determined for a variety of constellations, for example, number of first through third degree relatives; named (grandfather, father, uncle, cousins, brothers); maternal, paternal relationships, and age of onset.
RESULTS
In the 635,443 males analyzed, 18,105 had PC. First-degree RRs ranged from 2.46 (=1 first-degree relative affected, CI = 2.39–2.53) to 7.65 (=4 first-degree relatives affected, CI = 6.28–9.23). Second-degree RRs for probands with 0 affected first-degree relatives ranged from 1.51 (≥1 second-degree relative affected, CI = 1.47–1.56) to 3.09 (≥5 second-degree relatives affected, CI = 2.32–4.03). Third-degree RRs with 0 affected first- and 0 affected second-degree relatives ranged from 1.15 (≥1 affected third-degree relative, CI = 1.12–1.19) to 1.50 (≥5 affected third-degree relatives, CI = 1.35–1.66). RRs based on age at diagnosis were higher for earlier age at diagnoses; for example, RR = 5.54 for ≥1 first-degree relative diagnosed before age 50 years (CI = 1.12–1.19) and RR = 1.78 for >1 second-degree relative diagnosed before age 50 years, CI = 1.33, 2.33. RRs for equivalent maternal versus paternal family history were not significantly different.
CONCLUSIONS
A more complete PC family history using close and distant relatives and age at diagnosis results in a wider range of estimates of individual RR that are potentially more accurate than RRs estimated from summary family history. The presence of PC in second- and even third-degree relatives contributes significantly to risk. Maternal family history is just as significant as paternal family history. PC RRs based on a proband's complete constellation of affected relatives will allow patients and care providers to make more informed screening, monitoring, and treatment decisions. Prostate © 2014 Wiley Periodicals, Inc.