单核苷酸多态性与前列腺癌的研究进展

前列腺癌是影响西方国家男性健康的常见恶性肿瘤,而单核苷酸多态性(SNPs)作为第3代遗传标记可以影响到前列腺癌的发生、发展及预后。相同SNPs在不同种族间和前列腺癌的关系可能存在差异;本文就与前列腺癌相关的基因进行分类,描述不同SNPs与前列腺癌的关系。SNPs可以预测前列腺癌治疗过程中可能的不良反应,同时也可预测前列腺癌的患病风险,但目前仍存在一定的局限。     

单核苷酸多态性与骨髓炎易感性关系的研究进展

骨髓炎目前仍是困扰骨科医师的一大难题。大量研究表明,遗传因素可能在骨髓炎的发病中起重要作用。单核苷酸多态性(SNPs)作为第3代遗传标记,在骨髓炎遗传易感性方面的研究越来越受关注。对骨髓炎易感性基因的单核苷酸多态性进行深入研究,有助于探索骨髓炎预防、诊断和治疗的新策略。本文就目前基因SNPs与骨髓炎易感性的研究进展作一...     

MDM4基因rs1563828与乳腺癌发病风险及发病年龄的相关性研究

目的 探讨murine double minute 4(MDM4)基因的单核苷酸多态性rs1563828(C＞T)在早发性乳腺癌人群中的分布、与乳腺癌发病风险的关联性及其与发病年龄的潜在关系.方法 本研究为病例-对照研究.采用飞行时间质谱分析法对124例早发性乳腺癌患者(发病年龄≤35岁)和101名健康对照者进行MDM4基因rs1563828(C＞T)基因型鉴定.采用x2检验比较基因型分布和发病风险的关系,应用非条件Logistic回归分析计算危险度,两组发病年龄比较采用t检验.结果 对照组MDM4基因rs1563828基因型的分布频率为CC 43.6％ (44/101)、CT 42.6％ (43/101)、TT13.9％(14/101),病例组则依次为42.7％(53/124)、46.0％(57/124)、11.3％(14/124);两组差异无统计学意义(x2=0.449,P=0.799).Logistic回归分析表明,在早发性乳腺癌人群中,以rs1563828的CC野生基因型为参照,含T基因型(CT,TT)并未改变乳腺癌的发病危险(OR=1.024,95％ CI:0.581～1.806,P=0.934).在乳腺癌人群中,TT基因型携带者的发病年龄低于CT/CC基因型携带者[(30±4)岁比(32±3)岁,P=0.028].结论 MDM4基因rs1563828(C＞T)多态性可能与早发性乳腺癌人群的遗传易感性关联微弱,尚需进一步明确;其TT基因型可能是发病年龄提前的危险因素.     

单核苷酸多态性与前列腺癌关系的研究进展

单核苷酸多态性(SNP)是第3代遗传标记,有许多显著的特性。近年来出现了许多新的检测SNP的研究方法,如TaqM an探针技术、基因芯片技术、变性高效液相色谱、基质辅助激光解吸附-电离飞行时间质谱和微测序技术等。SNP作为遗传标记在人类多种肿瘤的研究中取得了一定的进展,本文综述了与前列腺癌(PCa)相关的前列腺特异性抗原的应答元件、酶类、激素及其受体、细胞周期调节蛋白、细胞因子、粘附分子及维生素等基因的SNP与前列腺癌发生发展的关系,以探讨前列腺癌的发病机制。     

1667例汉族前列腺癌人群前列腺癌易感性基因多态性验证分析

目的:前列腺癌在工业化国家发病率居男性恶性肿瘤首位,在我国前列腺癌近年发病率不断上升,成为泌尿系统常见恶性肿瘤。本文通过前列腺癌基因多态性分析研究汉族人群前列腺癌易感性危险位点。方法:取1 667例前列腺癌患者与1 525例对照组外周血样双盲利用Sequenom技术进行40个前列腺癌危险位点的SNP分析。结果:40个公认的前列腺癌位点检测结果有16个位点与前列腺癌明显相关(P<0.05);同时发现在不同人种中位于8q24的1、2、5位点与10q11的MSMB编码区及22q13.2编码TTLL1/BIK区域共同决定前列腺癌易感性。结论:汉族前列腺癌人群前列腺癌基因多态性分析结果显示:rs1465618、rs721048、rs12621278、rs7679673、rs12653946、rs339331、rs1512268、rs10086908、rs16901979、rs1447295、rs10993994、rs10896449、rs902774、rs9600079、rs11649743、rs5759167与前列腺癌易感性明显相关。     

Clinical curiosity: cribriform-morular variant of papillary thyroid carcinoma

BACKGROUND: There is an increasing awareness of the association of papillary thyroid carcinoma and familial adenomatous polyposis (FAP). Although the incidence is rare, most tend to occur in women. Several authors have described a distinctive histologic variant of papillary thyroid carcinoma, the cribriform-morular variant, which is associated with FAP but also may be encountered in patients with non-FAP. This diagnosis may precede the symptoms of colorectal polyposis. METHODS: A healthy 36-year-old woman was seen with a left thyroid nodule, and a 34-year-old woman with FAP was seen with a right thyroid nodule; both masses were suspicious for papillary thyroid carcinoma. Both patients underwent total thyroidectomy. RESULTS: Pathologic examination of both specimens revealed papillary thyroid carcinoma, cribriform-morular variant. The first patient subsequently underwent colonoscopy, which was negative for polyposis. CONCLUSIONS: Patients diagnosed with the cribriform-morular variant of papillary thyroid cancer should be screened for the presence of FAP.     

单核苷酸多态性与结直肠癌关系研究进展

结直肠癌是一种多因素共同作用的疾病,对结直肠癌的研究应该从多基因水平考虑,单核苷酸多态性作为一种新的研究肿瘤基因改变的方法,在结直肠癌的研究中有重要作用.寻找结直肠癌特异性单核苷酸多态性,对筛选高危人群,预估发病风险,具有重要意义.     

Distinguishing classical papillary thyroid microcancers from follicular-variant microcancers

Background

Papillary thyroid microcarcinomas (mPTCs), tumors less than or equal to 1 cm, have been considered the same clinical entity as microfollicular-variant papillary thyroid microcarcinomas (mFVPTCs). The purpose of this study was to use population-level data to characterize differences between mFVPTC and mPTC.

Materials and methods

We identified adult patients diagnosed with mFVPTC or mPTC between 1998 and 2010 in the Surveillance, Epidemiology, and End Results database. Binary comparisons were made with the Student t-test and chi-squared test. Multivariate logistic regression was used to further analyze lymph node metastases and multifocality.

Results

Of the 30,926 cases, 8697 (28.1%) were mFVPTC. Multifocal tumors occurred with greater frequency in the mFVPTC group compared with the mPTC group (35.4% versus 31.7%; P < 0.01). Multivariate logistic regression indicated that patients with mFVPTC had a 26% increased risk of multifocality (odds ratio, 1.26; 95% confidence interval, 1.2–1.4; P < 0.01). In contrast, lymph node metastases were nearly twice as common in the mPTC group compared with the mFVPTC group (6.8% versus 3.6%; P < 0.01). Multivariate logistic regression confirmed that patients with mPTC had a 69% increased risk of lymph node metastases compared with patients with mFVPTC (odds ratio, 1.69; 95% confidence interval, 1.4–2.0; P < 0.01).

Conclusions

Multifocality is not unique to classical mPTC and occurs more often in mFVPTC. The risk of lymph node metastases is greater for mPTC than mFVPTC. The surgeon should be aware of these features as they may influence the treatment for these microcarcinomas.     

Invasive follicular variant of papillary thyroid cancer harboring the NRAS mutation Q61K and presenting with bone metastasis—A case report

IntroductionThe follicular variant of papillary thyroid cancer (FVPTC) can be noninvasive or invasive. The invasive form of FVPTC commonly harbors BRAF mutations whereas RAS mutations are more often associated with noninvasive FVPTC and a favorable clinical outcome.Case reportA 47-year-old man presented with a metastasis to his right iliac bone as the initial manifestation of a 1.6 cm invasive FVPTC. After total thyroidectomy, the patient underwent additional treatment, including thyroid hormone suppressive treatment to non-detectable TSH levels, repeated courses of radioiodine treatment, external beam radiation, and treatment with the tyrosine kinase inhibitor sorafenib. Despite these therapeutic efforts, the disease progressed with growth of the iliac mass and additional metastatic spread to cervical and lumbar vertebrae causing increasing pain and disability. The patient succumbed to the disease four years after presentation. Retrospective next-generation sequencing of the primary tumor using a pan-cancer targeted mutation and gene fusion panel revealed NRAS Q61K mutation and no other oncogenic alterations.DiscussionThe study challenges the concept that thyroid neoplasms with isolated RAS mutations are often associated with favorable clinical behavior and may be candidates for conservative management.ConclusionAn isolated RAS mutation in invasive FVPTC may be associated with an aggressive clinical behavior.     

Genetic polymorphisms in CYP17, CYP3A4, CYP19A1, SRD5A2, IGF-1, and IGFBP-3 and prostate cancer risk in African-American men: the Flint Men's Health Study

BACKGROUND: Association studies have examined the significance of several candidate genes based on biological pathways relevant to prostate carcinogenesis, including both the androgen and insulin-like growth factor pathways. Clinical and epidemiologic evidence suggest that androgens, specifically testosterone and dihydrotestosterone (DHT) are important not only in normal prostate growth but in the pathogenesis of prostate cancer. Similarly, the insulin-like growth factor-1 (IGF-1) signaling pathway regulates both cellular proliferation and apoptosis. Therefore, genes involved in the biosynthesis, activation, metabolism and degradation of androgens and the stimulation of mitogenic and antiapoptotic activities of prostate epithelial cells represent important candidates for affecting the development and progression of prostate cancer. METHODS: Using resources from the Flint Men's Health Study, a population-based case control study of African-American men aged 40-79, we evaluated the associations between selected single-nucleotide polymorphisms (SNPs) in the CYP17, CYP3A4, CYP19A1, SDR5A2, IGF1, and IGFBP3 genes and prostate cancer diagnosis in 473 men (131 prostate cancer cases and 342 disease-free controls). RESULTS: We found a significant association between prostate cancer and selected CYP17 SNP genotypes, with the heterozygous genotype conferring decreased risk. Suggestive evidence for association between IGF1 SNPs and prostate cancer were also found. No significant associations were observed between SNPs in the other genes and prostate cancer. CONCLUSIONS: These findings suggest that variation in or around CYP17 and/or IGF1 may be associated with prostate cancer development in the African-American population. Additional studies are needed to determine whether these polymorphisms are indeed associated with prostate cancer risk in African Americans.     

前列腺癌易感基因遗传多态性的研究进展

随着人类基因组研究计划(human genome project,HGP)DNA序列测定和分析研究工作的深入发展,单核苷酸多态性(single nucleotide polymorphism,SNP)作为第三代遗传标记已经广泛应用于人群复杂性疾病易感性机制和个体化治疗方案的设计方面的研究。本文就与前列腺癌相关的遗传易感基因SNP进行了综述,主要阐述了细胞因子、受体以及相关酶类遗传多态性与前列腺癌发生之间的关系并分析其在前列腺癌治疗等方面的作用。     

Differentiated thyroid cancer associated with intestinal polyposis syndromes: A review

Intestinal polyposis syndromes, such as familial adenomatous polyposis (FAP) and Cowden's syndrome, are often associated with extraintestinal manifestations, and while many of these manifestations are benign, malignant extraintestinal manifestations, such as differentiated thyroid cancers, do occur. Although differentiated thyroid cancers (ie, papillary and follicular thyroid carcinomas) are associated with multiple syndromes, they are most commonly associated with intestinal polyposis syndromes. In the general population, the probability of developing thyroid cancer by age 65 years is only .5%. However, 1% to 2% of patients with FAP develop papillary thyroid carcinoma, the most common extraintestinal malignancy in patients with FAP. Also, up to 10% of patients with Cowden's syndrome will develop follicular thyroid carcinoma. The purpose of this review was to provide an overview of FAP, Cowden's syndrome, and Peutz‐Jeghers syndrome, to discuss in detail the associations between intestinal polyposis syndromes and differentiated thyroid cancers, and to provide suggestions for screening and managing these diseases. © 2009 Wiley Periodicals, Inc. Head Neck, 2009     

Prostate Cancer (PCa) Risk Variants and Risk of Fatal PCa in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium

Background

Screening and diagnosis of prostate cancer (PCa) is hampered by an inability to predict who has the potential to develop fatal disease and who has indolent cancer. Studies have identified multiple genetic risk loci for PCa incidence, but it is unknown whether they could be used as biomarkers for PCa-specific mortality (PCSM).

Objective

To examine the association of 47 established PCa risk single-nucleotide polymorphisms (SNPs) with PCSM.

Design, setting, and participants

We included 10 487 men who had PCa and 11 024 controls, with a median follow-up of 8.3 yr, during which 1053 PCa deaths occurred.

Outcome measurements and statistical analysis

The main outcome was PCSM. The risk allele was defined as the allele associated with an increased risk for PCa in the literature. We used Cox proportional hazards regression to calculate the hazard ratios of each SNP with time to progression to PCSM after diagnosis. We also used logistic regression to calculate odds ratios for each risk SNP, comparing fatal PCa cases to controls.

Results and limitations

Among the cases, we found that 8 of the 47 SNPs were significantly associated (p < 0.05) with time to PCSM. The risk allele of rs11672691 (intergenic) was associated with an increased risk for PCSM, while 7 SNPs had risk alleles inversely associated (rs13385191 [C2orf43], rs17021918 [PDLIM5], rs10486567 [JAZF1], rs6465657 [LMTK2], rs7127900 (intergenic), rs2735839 [KLK3], rs10993994 [MSMB], rs13385191 [C2orf43]). In the case-control analysis, 22 SNPs were associated (p < 0.05) with the risk of fatal PCa, but most did not differentiate between fatal and nonfatal PCa. Rs11672691 and rs10993994 were associated with both fatal and nonfatal PCa, while rs6465657, rs7127900, rs2735839, and rs13385191 were associated with nonfatal PCa only.

Conclusions

Eight established risk loci were associated with progression to PCSM after diagnosis. Twenty-two SNPs were associated with fatal PCa incidence, but most did not differentiate between fatal and nonfatal PCa. The relatively small magnitudes of the associations do not translate well into risk prediction, but these findings merit further follow-up, because they may yield important clues about the complex biology of fatal PCa.

Patient summary

In this report, we assessed whether established PCa risk variants could predict PCSM. We found eight risk variants associated with PCSM: One predicted an increased risk of PCSM, while seven were associated with decreased risk. Larger studies that focus on fatal PCa are needed to identify more markers that could aid prediction.     

Association of prostate cancer risk alleles with unfavourable pathological characteristics in potential candidates for active surveillance

Study Type – Prognosis (cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Men fail active surveillance for a variety of reasons; however, no single reliable biomarker has been found to date which will identify these men from the outset. We know that there are about 35 prostate cancer risk alleles which have been discovered to influence risk of prostate cancer, from large‐scale genome‐wide association studies. Some of these have been associated with aggressive prostate cancer. Nobody has examined the potential for these risk alleles to predict men who might fail active surveillance. This study adds to the growing evidence that single nucleotide polymorphisms may be able to identify men who have aggressive prostate cancers, and that this could be part of a risk algorithm used in active surveillance protocols.

OBJECTIVE

• ? To assess whether the carrier status of 35 risk alleles for prostate cancer (CaP) is associated with having unfavourable pathological features in the radical prostatectomy specimen in men with clinically low risk CaP who fulfil commonly accepted criteria as candidates for active surveillance.

PATIENTS AND METHODS

• ? We studied men of European ancestry with CaP who fulfilled the commonly accepted clinical criteria for active surveillance (T1c, prostate‐specific antigen <10 ng/mL, biopsy Gleason ≤6, three or fewer positive cores, ≤50% tumour involvement/core) but instead underwent early radical prostatectomy.
• ? We genotyped these men for 35 CaP risk alleles. We defined ‘unfavourable’ pathological characteristics to be Gleason ≥7 and/or ≥ pT2b in their radical prostatectomy specimen.

RESULTS

• ? In all, 263 men (median age 60 [46–72] years) fulfilled our selection criteria for active surveillance, and 58 of 263 (22.1%) were found to have ‘unfavourable’ pathological characteristics.
• ? The frequencies of three CaP risk alleles (rs1447295 [8q24], P= 0.004; rs1571801 [9q33.2], P= 0.03; rs11228565 [11q13], P= 0.02) were significantly higher in men with ‘unfavourable’ pathological characteristics.
• ? Two other risk alleles were proportionately more frequent (rs10934853 [3q21], P= 0.06; rs1859962 [17q24], P= 0.07) but did not achieve nominal statistical significance.
• ? Carriers of any one of the significantly over‐represented risk alleles had twice the likelihood of unfavourable tumour features (P= 0.03), and carriers of any two had a sevenfold increased likelihood (P= 0.001).
• ? Receiver–operator curve analysis demonstrated an area under the curve of 0.66, suggesting that the number of single nucleotide polymorphisms carried provided discrimination between men with ‘favourable’ and ‘unfavourable’ tumour features in their prostatectomy specimen.

CONCLUSION

• ? In potential candidates for active surveillance, certain CaP risk alleles are more prevalent in patients with ‘unfavourable’ pathological characteristics in their radical prostatectomy specimen.