遗传因素与脑胶质细胞瘤的相关意义

背景脑肿瘤的危险因素已经有许多流行病学调查研究,同时从群体遗传学角度对其研究尚需探讨.目的揭示脑胶质细胞瘤是否与遗传因素有关及关联的程度和遗传的方式等.设计以诊断为依据的病例对照研究.地点与对象选择1989-09/2000-09在黑龙江省六大医院神经外科住院的80例患者为病例组,所有患者经外科摘除手术和病理诊断为原发、初发脑胶质细胞瘤,在上述医院其他外科病房选择同期住院、性别相同、年龄同一段(±2.5岁)、居住地相同或相近、排除肿瘤和头部疾病的其他患者(共160例)作为对照组.方法采用1∶2配比病例对照研究方法,按标准化调查表中项目当面采访.主要观察指标与对照组比较家族史、曾患率,与人群比较发病率,估算遗传率.结果在80例脑胶质细胞瘤患者中,有家族史者3例,而在160例对照中,无家族史存在(P=0.036);病例组一级亲属该病曾患率为4.73/10000,对照组一级亲属中无人患病(P=0.037);病例组一级亲属该病曾患率与人群发病率比较,差异有显著性意义(u=231.56,P＜0.000 5);病例组一级亲属该病遗传率为56%.结论脑胶质细胞瘤具有遗传倾向,且不符合单基因显性遗传的1/2或隐性遗传的1/4规律,可能与多基因遗传有关,环境因素的作用也不容忽视.

Hereditary factors and cerebral glioma

BACKGROUND: Many epidemiological studies investigated risk factors for cerebral tumours; however, there are lacks of studies on the genetic epidemiology of glioma.OBJECTIVE: To investigate the extent and the form of heritability of glioma.DESIGN: A case-control study based on diagnosis.SETTING and PARTICIPANTS: Eighty patients with a diagnosis of glioma and 160 age, gender and living environment matched subjects who were undergoing surgeries for disorders other than tumours and without cerebral involvement were recruited from 6 major hospitals in Heilongjiang Province from September 1989 to September 2000.METHODS: According to the items of standard questionnaire, interview was performed among the patients and controls at a ratio of 1: 2.MAIN OUTCOME MEASURES: The hereditability was estimated by comparison of family history, past history and incidence of turnour between glioma and control groups.RESULTS: Three of 80 glioma patients had family history, while none of 160 control subjects had family history(P=0.036) . The incidence of giloma was 4. 73/1 000 and 0 in the first-degree relatives of giloma patients and that of control subjects, respectively( P = 0. 037). here was a significant difference in incidence of glioma between in the first-degree relatives of giloma patients and in the general population( u =231.56, P ＜ 0. 000 5) . The hereditability of glioma was estimated as 56% in the first-degree relatives of giloma patients.CONCLUSION: Glioma is intended to be hereditable. However, its hereditability is in a form of neither the 1/2 single gene dominant inheritance nor the 1/4 recessive inheritance. Glioma may result from an interaction between multigene and environmental factors.