Zusammenfassung
Hintergrund: Neben Zigarettenrauchen und Alkoholkonsum sind genetische Faktoren in der Entstehung von Kopf-Hals-Karzinomen von Bedeutung. Kandidaten dafür sind Mikrosatelliten-Polymorphismen in den Klasse 3-Genen des Major Histocompatibility Complex (MHC), die den Tumor Nekrose Faktor (TNF) beeinflussen. Methode: In einer Fall-Kontroll-Studie wurden 113 Kontrollpersonen, 265 Larynxkarzinompatienten und 123 Patienten mit Mundhöhlen- und Pharynxkarzinomen untersucht. Die Genotypen wurden nach PCR und Elektrophorese in einem DNA-Sequenzierer bestimmt. Ergebnisse: Die Häufigkeit eines Allels (B3) war bei Larynxkarzinompatienten signifikant häufiger nachweisbar und stellt somit ein Risikoallel dar. Bei Vorliegen des homozygoten Genotyps stieg das Erkrankungsrisiko für Larynxkarzinome deutlich an. Schlussfolgerungen: Die Ergebnisse zeigen einen Einfluss von Variationen in MHC Klasse 3-Genen auf die Entstehung von Larynxkarzinomen.
Influence of Genetic Variation in the Major Histocompatibility Complex on Head and Neck Cancer Susceptibility
Background: While cigarette smoking and alcohol consumption are risk factors for squamous cell carcinomas (SCC) of the head and neck, genetic factors are also significant. The gene of tumor necrosis factor (TNF) is located in the major histocompatibility complex class III and the cytokine has pleiotropic actions some of which are anticarcinogenic. As this gene complex is polymorphic with microsatellite markers identified it is a further candidate for head and neck cancer susceptibility. Methods: We used a case-control approach to study the influence of polymorphism at the A-D markers on susceptibility in 113 controls, 265 laryngeal and 123 oral cavity/pharyngeal SCC cases. Genotypes were identified on polyacrylamide gels in an automated DNA sequencer after amplification with fluorescently-labeled primers. Results: We found no differences in allele frequencies between controls and oral cavity/pharyngeal SCC cases but the frequency of B3 was greater in the laryngeal SCC cases than controls (p = 0.004, odds ratio 2.8). Homozygosity for B3 conferred an increased risk of laryngeal cancer compared with controls (p = 0.021, odds ratio 10.8). Conclusions: The data provide the first evidence that allelism at MHC class III microsatellite markers is associated with risk to laryngeal SCC.
Schlüsselwörter:
MHC - TNF - Larynxkarzinom - Pharynxkarzinom - Mikrosatelliten - Erkrankungsrisiko
Key words:
MHC - TNF - Pharyngeal cancer - Laryngeal cancer - Susceptibility - Microsatellites
Literatur
1
Blitzer P H.
Epidemiology of head and neck cancer.
Semin Oncol.
1988;
15
2-9
2
Boring C C, Squires T S, Tong T, Montgomery S.
Cancer statistics 1994.
CA Cancer J Clin.
1994;
44
7-26
3
Muir C, Weiland L.
Upper aerodigestive tract cancers.
Cancer.
1995;
75
147-153
4
Blot W J, McLaughlin J K, Winn D M.
Smoking and drinking in relation to oral and pharyngeal cancer.
Cancer Res.
1988;
48
3282-3287
5
Brugere J, Guenel P, Leclerc A, Rodriguez J.
Differential effects of tobacco and alcohol in cancer of the larynx, pharynx and mouth.
Cancer.
1986;
57
391-395
6
Elwood J M, Pearson J CG, Skippen D H, Jackson S M.
Alcohol, smoking, social and occupational factors in the etiology of cancer of the oral cavity, pharynx and larynx.
Int J Cancer.
1984;
34
603-612
7
Bongers V, Braakhuis B JM, Tobi H, Lubsen H, Snow G B.
The relation between cancer incidence among relatives and the occurrence of multiple primary carcinomas following head and neck cancer.
Cancer Epidemiol Biomarkers Prev.
1996;
5 (8)
585-598
8
Copper M P, Jovanovic A, Nauta J JP, Braakhuis B JM, DeVries N, van der Waal L P, Snow G B.
Role of genetic factors in the etiology of squamous cell carcinoma of the head and neck.
Arch Otolaryngol.
1995;
121
157-160
9
Harris C C.
Chemical and physical carcinogenesis: advances and perspectives for the 1990s.
Cancer Res.
1991;
51
5023-5044
10
Matthias C, Bockmühl U, Jahnke V, Jones P W, Hayes J, Alldersea J, Gilford J, Bailey L, Bath J, Worrall S F, Hand P, Fryer A A, Strange R C.
Polymorphism in cytochrome P450 CYP2D6, CYP1A1, CYP2E1 and glutathione-S-transferase, GSTM1, GSTM3, GSTT1 and susceptibility to tobacco-related cancers: studies in upper aerodigestive tract cancers.
Pharmacogenetics.
1998;
8
91-100
11 Roots I, Drakoulis N, Brockmöller J. Polymorphic enzymes and cancer risk: concepts, methodology, and data review. In: Kalow W (Hrsg) Pharmacogenetics of drug metabolism. New York; Pergamon Press 1992: 815
12
Webb G C, Chaplin D D.
Genetic variability at the human tumor necrosis factor loci.
J Immunol.
1990;
145
1278-1285
13
Pociot F, Briant L, Jongeneel C V, Molvig J, Worsaae H, Abbal M, Thomsen M, Nerup J, Chambon-Thomsen A.
Association of tumor necrosis factor (TNF) and class II major histocompatibility complex alleles with the secretion of TNF-α and TNF-β by human mononuclear cells: a possible link to insulin-dependent diabetes mellitus.
Eur J Immunol.
1993;
23
224-231
14
Larrick J W, Wright S C.
Cytotoxic mechanism of tumor necrosis factor.
Faseb J.
1990;
4
3215-3218
15
Old L J.
Tumor necrosis factor (TNF).
Science.
1985;
230
630-632
16
Chouaib S C, Asselin-Paturel F, Mami-Chouaib F, Caignard A, Blay J Y.
The host-immune conflict: from immunosuppression to resistence and destruction.
Immunol Today.
1997;
18 (10)
493-497
17
Eigler A, Sinha B, Hartmann G, Endres S.
Taming TNF: strategies to restrain this proinflammatory cytocine.
Immunol Today.
1997;
18 (10)
487-492
18
Parks R R, Yan S D, Huang C C.
Tumor necrosis factor-α production in human head and neck squamous cell carcinoma.
Laryngoscope.
1994;
104
860-864
19
Hajeer A H, Worthington J, Silman A J, Ollier W R.
Association of tumor necrosis factor microsatellite polymorphisms with HLA-DRB1*04-bearing haplotypes in rheumatoid arthritis patients.
Arthritis Rheum.
1996;
39
1109-1114
20
Monos D S, Kamoun M, Udalova I A, Csanky E, Cizman B, Turetskaya R L, Smirnova J B, Zharkov V G, Gasser D, Zmijewski C M, Spielman R S, Nedospasov S A.
Genetic polymorphism of the human tumor necrosis factor region in insulin-dependent diabetes mellitus. Linkage disequilibrium of TNFab microsatellite alleles with HLA haplotypes.
Hum Immunol.
1995;
44
70-79
21 Hermanek P, Sobin L H (Hrsg). TNM Classification of malignant tumors (4. Aufl.) Berlin; Springer, UICC Union Internationale Contre le Cancer 1987
22
Udalova I A, Nedospasov S A, Webb G C, Chaplin D D, Turetskaya R L.
Highly informative typing of the human TNF locus using six adjacent polymorphic markers.
Genomics.
1993;
16
180-186
23
Matthias C, Branigan K, Jahnke V, Leder K, Haas J, Heighway J, Jones P W, Strange R C, Fryer A A, Hoban P R.
Polymorphism within the cyclin D1 gene is associated with prognosis in patients with squamous cell carcinoma of the head and neck.
Clin Cancer Res.
1998;
4
2411-2418
24
McManus R, Moloney M, Borton M, Finch A, Chuan Y T, Lawlor E, Weir D G, Kelleher D.
Association of celiac disease with microsatellite polymorphisms close to tumor necrosis factor genes.
Hum Immunol.
1996;
45
24-31
25
Hajeer A H, Worthington J, Davies E J, Hillarby M C, Poulton K, Ollier W R.
TNF microsatellite a2, b3 and d2 alleles are associated with systemic lupus erythematosus.
Tissue Antigens.
1997;
49
222-227
26
Honchel R, McDonnell S, Schaid D J, Thibodeau S N.
Tumor necrosis factor-α allelic frequency and chromosome 6 allelic imbalance in patients with colorectal cancer.
Cancer Res.
1996;
56
145-149
27
Field J K, Kiaris H, Howard P, Vaughan E D, Spandidos D A, Jones A S.
Microsatellite instability in squamous cell carcinoma of the head and neck.
Br J Cancer.
1995;
71
1065-1069
28
Field J K, Kiaris H, Risk J M, Tsiriyotis C, Adamson R, Zoumpourlis V, Rowley H, Taylor K, Whittaker J, Howard P, Beirne J C, Gosney J R, Woolgar J, Vaughan E D, Spandidos D A, Jones A S.
Allelotype of squamous cell carcinoma of the head and neck: fractional allele loss correlates with survival.
Br J Cancer.
1995;
72
1180-1188
29
Wooster R, Cleton-Jansen A M, Collins N, Manjion J, Cornelis R S, Cooper C S, Gusterson B A, Ponder B AJ, von Deimling A, Wiestler O D, Cornelisse C J, Devilee P, Stratton M R.
Instability of short tandem repeats (microsatellites) in human cancers.
Nature Genet.
1994;
6
152-156
30
Wilson A G, De Vries N, Pocoit F, di Giovine F S, van der Putte L BA, Duff G W.
An allelic polymorphism within the tumor necrosis factor-α promoter region is strongly associated with HLA A1, B8 and DR 3 alleles.
J Exp Med.
1993;
177
557-581
31
Carroll M C, Katzman P, Alicot E A.
Linkage or resistance to lysis by alloreactive natural killer cells is governed by a gene in the human major histocompatibility complex between BF and HLA-B.
Proc Natl Acad Sci.
1990;
87
9794-9799
32
Knerer B, Hulla W, Martinek H.
IL-1 and TNF-α but no IL-2 expression is found in squamous cell carcinomas of the head and neck by RT-PCR.
Acta Otolaryngol (Stockh).
1996;
116
132-136
33
Vilcek J, Lee T H.
Tumor necrosis factor.
J Biol Chem.
1991;
266
7313-7316
34
DeVries N, Drexhage H H, van de Waal L P.
Human leukocyte antigens and immunoglobulin allotypes in head and neck cancer patients with and without multiple primary tumors.
Cancer.
1987;
60
957-961
Priv.-Doz. Dr. Christoph Matthias
HNO-Klinik der Charité, Campus Virchow-Klinikum der Humboldt-Universität
Augustenburger Platz 1 13353 Berlin
eMail: christoph.matthias@charite.de