1
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Ward SV, Drill EN, Begg CB. Aggregation of melanoma tumour site within Western Australian families. Cancer Epidemiol 2024; 90:102580. [PMID: 38701695 DOI: 10.1016/j.canep.2024.102580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Evidence is emerging that melanoma has distinct aetiologic pathways and subtypes, characterized by factors like anatomic site of the tumour. To explore genetic influences on anatomic subtypes, we examined the extent to which melanomas in first-degree relatives shared the same body site of occurrence. METHODS Population-level linked data was used to identify the study population of over 1.5 million individuals born in Western Australia between 1945 and 2014, and their first-degree relatives. There were 1009 pairs of invasive tumours from 677 family pairs, each categorised by anatomic site. Greater than expected representation of site-concordant pairs would suggest the presence of genetic factors that predispose individuals to site-specific melanoma. RESULTS Comparing observed versus expected totals, we observed a modest increase in site concordance for invasive head/neck and truncal tumours (P=0.02). A corresponding analysis including in situ tumours showed a similar concordance (P=0.05). No further evidence of concordance was observed when stratified by sex. CONCLUSION In conclusion, modest evidence of aggregation was observed but with inconsistent patterns between sites. Results suggest that further investigation into the familial aggregation of melanoma by tumour site is warranted, with the inclusion of genetic data in order to disentangle the relative contributions of genetic and environmental factors.
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Affiliation(s)
- Sarah V Ward
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, Australia; Medical School, The University of Western Australia, 35 Stirling Highway,Crawley, Western Australia, Australia; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, New York, NY 10017, USA.
| | - Esther N Drill
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, New York, NY 10017, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 633 3rd Avenue, New York, NY 10017, USA
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2
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Venanzi Rullo E, Maimone MG, Fiorica F, Ceccarelli M, Guarneri C, Berretta M, Nunnari G. Non-Melanoma Skin Cancer in People Living With HIV: From Epidemiology to Clinical Management. Front Oncol 2021; 11:689789. [PMID: 34422644 PMCID: PMC8371466 DOI: 10.3389/fonc.2021.689789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/07/2021] [Indexed: 12/13/2022] Open
Abstract
Skin cancers represent the most common human tumors with a worldwide increasing incidence. They can be divided into melanoma and non-melanoma skin cancers (NMSCs). NMSCs include mainly squamous cell (SCC) and basal cell carcinoma (BCC) with the latest representing the 80% of the diagnosed NMSCs. The pathogenesis of NMSCs is clearly multifactorial. A growing body of literature underlies a crucial correlation between skin cancer, chronic inflammation and immunodeficiency. Intensity and duration of immunodeficiency plays an important role. In immunocompromised patients the incidence of more malignant forms or the development of multiple tumors seems to be higher than among immunocompetent patients. With regards to people living with HIV (PLWH), since the advent of combined antiretroviral therapy (cART), the incidence of non-AIDS-defining cancers (NADCs), such as NMSCs, have been increasing and now these neoplasms represent a leading cause of illness in this particular population. PLWH with NMSCs tend to be younger, to have a higher risk of local recurrence and to have an overall poorer outcome. NMSCs show an indolent clinical course if diagnosed and treated in an early stage. BCC rarely metastasizes, while SCC presents a 4% annual incidence of metastasis. Nevertheless, metastatic forms lead to poor patient outcome. NMSCs are often treated with full thickness treatments (surgical excision, Mohs micro-graphic surgery and radiotherapy) or superficial ablative techniques (such as cryotherapy, electrodesiccation and curettage). Advances in genetic landscape understanding of NMSCs have favored the establishment of novel therapeutic strategies. Concerning the therapeutic evaluation of PLWH, it’s mandatory to evaluate the risk of interactions between cART and other treatments, particularly antiblastic chemotherapy, targeted therapy and immunotherapy. Development of further treatment options for NMSCs in PLWH seems needed. We reviewed the literature after searching for clinical trials, case series, clinical cases and available databases in Embase and Pubmed. We review the incidence of NMSCs among PLWH, focusing our attention on any differences in clinicopathological features of BCC and SCC between PLWH and HIV negative persons, as well as on any differences in efficacy and safety of treatments and response to immunomodulators and finally on any differences in rates of metastatic disease and outcomes.
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Affiliation(s)
- Emmanuele Venanzi Rullo
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria Grazia Maimone
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Fiorica
- Department of Radiation Oncology and Nuclear Medicine, State Hospital "Mater Salutis" Azienda Unità Locale Socio Sanitaria (AULSS) 9, Legnago, Italy
| | - Manuela Ceccarelli
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Claudio Guarneri
- Unit of Dermatology, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Massimiliano Berretta
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Nunnari
- Unit of Infectious Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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3
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Vidovic D, Simms GA, Pasternak S, Walsh M, Peltekian K, Stein J, Helyer LK, Giacomantonio CA. Case Report: Combined Intra-Lesional IL-2 and Topical Imiquimod Safely and Effectively Clears Multi-Focal, High Grade Cutaneous Squamous Cell Cancer in a Combined Liver and Kidney Transplant Patient. Front Immunol 2021; 12:678028. [PMID: 34122442 PMCID: PMC8190543 DOI: 10.3389/fimmu.2021.678028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/07/2021] [Indexed: 01/04/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common non-melanoma skin cancer worldwide, with ever increasing incidence and mortality. While most patients can be treated successfully with surgical excision, cryotherapy, or radiation therapy, there exist a subset of patients with aggressive cSCC who lack adequate therapies. Among these patients are solid organ transplant recipients who due to their immunosuppression, develop cSCC at a dramatically increased rate compared to the normal population. The enhanced ability of the tumor to effectively undergo immune escape in these patients leads to more aggressive tumors with a propensity to recur and metastasize. Herein, we present a case of aggressive, multi-focal cSCC in a double organ transplant recipient to frame our discussion and current understanding of the immunobiology of cSCC. We consider factors that contribute to the significantly increased incidence of cSCC in the context of immunosuppression in this patient population. Finally, we briefly review current literature describing experience with localized therapies for cSCC and present a strong argument and rationale for consideration of an IL-2 based intra-lesional treatment strategy for cSCC, particularly in this immunosuppressed patient population.
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Affiliation(s)
- Dejan Vidovic
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Gordon A. Simms
- Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Sylvia Pasternak
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Mark Walsh
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Kevork Peltekian
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - John Stein
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Lucy K. Helyer
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
| | - Carman A. Giacomantonio
- Department of Surgery, Faculty of Medicine, Dalhousie University, Halifax Regional Municipality, NS, Canada
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Bai D, Yip BHK, Windham GC, Sourander A, Francis R, Yoffe R, Glasson E, Mahjani B, Suominen A, Leonard H, Gissler M, Buxbaum JD, Wong K, Schendel D, Kodesh A, Breshnahan M, Levine SZ, Parner ET, Hansen SN, Hultman C, Reichenberg A, Sandin S. Association of Genetic and Environmental Factors With Autism in a 5-Country Cohort. JAMA Psychiatry 2019; 76:1035-1043. [PMID: 31314057 PMCID: PMC6646998 DOI: 10.1001/jamapsychiatry.2019.1411] [Citation(s) in RCA: 288] [Impact Index Per Article: 57.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
IMPORTANCE The origins and development of autism spectrum disorder (ASD) remain unresolved. No individual-level study has provided estimates of additive genetic, maternal, and environmental effects in ASD across several countries. OBJECTIVE To estimate the additive genetic, maternal, and environmental effects in ASD. DESIGN, SETTING, AND PARTICIPANTS Population-based, multinational cohort study including full birth cohorts of children from Denmark, Finland, Sweden, Israel, and Western Australia born between January 1, 1998, and December 31, 2011, and followed up to age 16 years. Data were analyzed from September 23, 2016 through February 4, 2018. MAIN OUTCOMES AND MEASURES Across 5 countries, models were fitted to estimate variance components describing the total variance in risk for ASD occurrence owing to additive genetics, maternal, and shared and nonshared environmental effects. RESULTS The analytic sample included 2 001 631 individuals, of whom 1 027 546 (51.3%) were male. Among the entire sample, 22 156 were diagnosed with ASD. The median (95% CI) ASD heritability was 80.8% (73.2%-85.5%) for country-specific point estimates, ranging from 50.9% (25.1%-75.6%) (Finland) to 86.8% (69.8%-100.0%) (Israel). For the Nordic countries combined, heritability estimates ranged from 81.2% (73.9%-85.3%) to 82.7% (79.1%-86.0%). Maternal effect was estimated to range from 0.4% to 1.6%. Estimates of genetic, maternal, and environmental effects for autistic disorder were similar with ASD. CONCLUSIONS AND RELEVANCE Based on population data from 5 countries, the heritability of ASD was estimated to be approximately 80%, indicating that the variation in ASD occurrence in the population is mostly owing to inherited genetic influences, with no support for contribution from maternal effects. The results suggest possible modest differences in the sources of ASD risk between countries.
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Affiliation(s)
- Dan Bai
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Benjamin Hon Kei Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gayle C. Windham
- Center for Health Communities, Environmental Health Investigations Branch, California Department of Public Health, Richmond
| | - Andre Sourander
- Department of Child Psychiatry, Turku University, Turku University Hospital, Turku, Finland
| | - Richard Francis
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | | | - Emma Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | - Behrang Mahjani
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York
| | - Auli Suominen
- Department of Child Psychiatry, Turku University, Turku University Hospital, Turku, Finland
| | - Helen Leonard
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | - Mika Gissler
- Department of Child Psychiatry, Turku University, Turku University Hospital, Turku, Finland,Information Services Department, National Institute for Health and Welfare, Helsinki, Finland,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Joseph D. Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kingsley Wong
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | - Diana Schendel
- Department of Public Health, Aarhus University, Aarhus, Denmark,Department of Economics and Business, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark,iPSYCH, Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus University, Aarhus, Denmark
| | - Arad Kodesh
- Department of Community Mental Health, University of Haifa, Haifa, Israel,Meuhedet Health Services, Israel
| | - Michaeline Breshnahan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York,New York State Psychiatric Institute, New York
| | - Stephen Z. Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Erik T. Parner
- Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Stefan N. Hansen
- Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christina Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York,The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York
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Wang W, Ollila HM, Whittemore AS, Demehri S, Ioannidis NM, Jorgenson E, Mignot E, Asgari MM. Genetic variants in the HLA class II region associated with risk of cutaneous squamous cell carcinoma. Cancer Immunol Immunother 2018; 67:1123-1133. [PMID: 29754218 DOI: 10.1007/s00262-018-2168-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/30/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The immune system has been implicated in the pathophysiology of cutaneous squamous cell carcinoma (cSCC) as evidenced by the substantially increased risk of cSCC in immunosuppressed individuals. Associations between cSCC risk and single nucleotide polymorphisms (SNPs) in the HLA region have been identified by genome-wide association studies (GWAS). The translation of the associated HLA SNPs to structural amino acids changes in HLA molecules has not been previously elucidated. METHODS Using data from a GWAS that included 7238 cSCC cases and 56,961 controls of non-Hispanic white ancestry, we imputed classical alleles and corresponding amino acid changes in HLA genes. Logistic regression models were used to examine associations between cSCC risk and genotyped or imputed SNPs, classical HLA alleles, and amino acid changes. RESULTS Among the genotyped SNPs, cSCC risk was associated with rs28535317 (OR = 1.20, p = 9.88 × 10- 11) corresponding to an amino-acid change from phenylalanine to leucine at codon 26 of HLA-DRB1 (OR = 1.17, p = 2.48 × 10- 10). An additional independent association was observed for a threonine to isoleucine change at codon 107 of HLA-DQA1 (OR = 1.14, p = 2.34 × 10- 9). Among the classical HLA alleles, cSCC was associated with DRB1*01 (OR = 1.18, p = 5.86 × 10- 10). Conditional analyses revealed additional independent cSCC associations with DQA1*05:01 and DQA1*05:05. Extended haplotype analysis was used to complement the imputed haplotypes, which identified three extended haplotypes in the HLA-DR and HLA-DQ regions. CONCLUSIONS Associations with specific HLA-DR and -DQ alleles are likely to explain previously observed GWAS signals in the HLA region associated with cSCC risk.
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Affiliation(s)
- Wei Wang
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Hanna M Ollila
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Alice S Whittemore
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Shadmehr Demehri
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, Suite 270, 02114, Boston, MA, USA
| | - Nilah M Ioannidis
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Eric Jorgenson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Emmanuel Mignot
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Maryam M Asgari
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, Suite 270, 02114, Boston, MA, USA. .,Department of Population Medicine, Harvard Medical School, Boston, MA, USA.
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6
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Wei L, Allain DC, Bernhardt MN, Gillespie JL, Peters SB, Iwenofu OH, Nelson HH, Arron ST, Toland AE. Variants at the OCA2/HERC2 locus affect time to first cutaneous squamous cell carcinoma in solid organ transplant recipients collected using two different study designs. Br J Dermatol 2017; 177:1066-1073. [PMID: 28456133 DOI: 10.1111/bjd.15618] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Variants at the oculocutaneous albinism 2 (OCA2)/HECT and RLD domain containing E3 ubiquitin protein ligase 2 (HERC2) locus have been associated with pigmentation phenotypes and risk of developing several types of skin cancer. OBJECTIVES To evaluate OCA2/HERC2 locus variants for their impact on time to develop cutaneous squamous cell carcinoma (cSCC) in organ transplant recipients (OTRs) who are at elevated risk of developing cSCC. METHODS Participants were solid OTRs ascertained from two centres (n = 125 and 261) with an average of 13·1 years of follow-up post-transplant. DNA was available for genotyping for all participants, in addition to medical records and questionnaire data. The Ohio State University study had a case-control design with prospective follow-up, and the University of California San Francisco study was a national cross-sectional survey with retrospective chart review. RESULTS OCA2 variants rs12913832 and rs916977 were significantly associated with time to first cSCC post-transplant. OTRs homozygous for the brown-eye alleles of rs916977 (GG) and rs12913832 (AA) had significant delays of time to first cSCC post-transplant compared with individuals homozygous for the blue-eye alleles (hazard ratio 0·34, P < 0·001 and hazard ratio 0·54, P = 0·012, respectively). Both variants were highly associated with eye colour in the combined studies (P < 0·001). CONCLUSIONS This study is the first to show an association between OCA2/HERC2 variants and time to first cSCC post-transplant. This may impact dermatological screening recommendations for high-risk populations.
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Affiliation(s)
- L Wei
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, OH, U.S.A
| | - D C Allain
- Department of Internal Medicine, Division of Human Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, U.S.A
| | - M N Bernhardt
- Department of Internal Medicine, Division of Human Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, U.S.A
| | - J L Gillespie
- Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, U.S.A
| | - S B Peters
- Department of Pathology, Division of Dermatopathology, The Ohio State University Wexner Medical Center, Columbus, OH, U.S.A
| | - O H Iwenofu
- Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, U.S.A
| | - H H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, U.S.A.,Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, U.S.A
| | - S T Arron
- Department of Dermatology, University of California San Francisco, San Francisco, CA, U.S.A
| | - A E Toland
- Department of Internal Medicine, Division of Human Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, U.S.A.,Department of Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, U.S.A
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7
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Yesantharao P, Wang W, Ioannidis NM, Demehri S, Whittemore AS, Asgari MM. Cutaneous squamous cell cancer (cSCC) risk and the human leukocyte antigen (HLA) system. Hum Immunol 2017; 78:327-335. [PMID: 28185865 DOI: 10.1016/j.humimm.2017.02.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/03/2017] [Accepted: 02/03/2017] [Indexed: 01/20/2023]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer among Caucasians in the United States, with rising incidence over the past decade. Treatment for non-melanoma skin cancer, including cSCC, in the United States was estimated to cost $4.8 billion in 2014. Thus, an understanding of cSCC pathogenesis could have important public health implications. Immune function impacts cSCC risk, given that cSCC incidence rates are substantially higher in patients with compromised immune systems. We report a systematic review of published associations between cSCC risk and the human leukocyte antigen (HLA) system. This review includes studies that analyze germline class I and class II HLA allelic variation as well as HLA cell-surface protein expression levels associated with cSCC risk. We propose biological mechanisms for these HLA-cSCC associations based on known mechanisms of HLA involvement in other diseases. The review suggests that immunity regulates the development of cSCC and that HLA-cSCC associations differ between immunocompetent and immunosuppressed patients. This difference may reflect the presence of viral co-factors that affect tumorigenesis in immunosuppressed patients. Finally, we highlight limitations in the literature on HLA-cSCC associations, and suggest directions for future research aimed at understanding, preventing and treating cSCC.
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Affiliation(s)
- Pooja Yesantharao
- Epidemiology Division, Department of Health Research & Policy, Stanford University, Stanford, CA 94305, USA
| | - Wei Wang
- Epidemiology Division, Department of Health Research & Policy, Stanford University, Stanford, CA 94305, USA
| | - Nilah M Ioannidis
- Epidemiology Division, Department of Health Research & Policy, Stanford University, Stanford, CA 94305, USA
| | - Shadmehr Demehri
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Alice S Whittemore
- Epidemiology Division, Department of Health Research & Policy, Stanford University, Stanford, CA 94305, USA.
| | - Maryam M Asgari
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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8
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Helgadottir H, Höiom V, Tuominen R, Jönsson G, Månsson-Brahme E, Olsson H, Hansson J. CDKN2a mutation-negative melanoma families have increased risk exclusively for skin cancers but not for other malignancies. Int J Cancer 2015; 137:2220-6. [PMID: 25943250 DOI: 10.1002/ijc.29595] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 04/23/2015] [Accepted: 04/29/2015] [Indexed: 01/05/2023]
Abstract
Germline CDKN2A mutations are found in 5-20% of melanoma families. Numerous studies have shown that carriers of CDKN2A mutations have increased risks of non-melanoma cancers, but so far there have been no studies investigating cancer risks in CDKN2A wild type (wt) melanoma families. In this prospective cohort study, index melanoma cases (n = 224) and their first-degree relatives (n = 944) were identified from 154 confirmed CDKN2A wt melanoma families. Cancer diagnoses in family members and matched controls were obtained from the Swedish Cancer Registry. Relative risks (RR), odds ratios (OR) and two-sided 95% confidence intervals (95% CI) were calculated. In index cases and first-degree relatives, the prospective RR for melanoma was 56.9 (95% CI 31.4-102.1) and 7.0 (95% CI 4.2-11.4), respectively, and for squamous cell skin cancers 9.1 (95% CI 6.0-13.7) and 3.4 (95% CI 2.2-5.2), respectively. In neither group, elevated risks were seen for non-skin cancers. In a subgroup analysis, CDKN2A wt melanoma families with young (<40 years) melanoma cases were found to have increased risk of non-skin cancers (RR 1.5, 95% CI 1.0-1.5). Further, MC1R gene variants were increased in familial melanoma cases compared to controls (OR 2.4, 95% CI 1.6-3.4). Our findings suggest that in the majority of CDKN2A wt melanoma families, a segregation of variants in low-risk melanoma genes such as MC1R causes increased skin cancer susceptibility, rather than mutations in high-risk cancer predisposing genes, such mutations are more probable to be found in melanoma families with young melanoma cases. This study further supports an implication of CDKN2A mutation screening as a clinical test that determines counseling and follows up routines of melanoma families.
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Affiliation(s)
- Hildur Helgadottir
- Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden
| | - Veronica Höiom
- Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden
| | - Rainer Tuominen
- Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden
| | - Göran Jönsson
- Department of Oncology, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Eva Månsson-Brahme
- Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden
| | - Håkan Olsson
- Department of Oncology, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Johan Hansson
- Department of Oncology Pathology, Karolinska Institutet and Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden
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9
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Asgari MM, Warton EM, Quesenberry CP, Koralek DO, Taylor M. Risk of subsequent cutaneous squamous cell carcinoma in patients with melanoma. J Am Acad Dermatol 2014; 71:521-8. [DOI: 10.1016/j.jaad.2014.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 04/10/2014] [Accepted: 04/11/2014] [Indexed: 11/30/2022]
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10
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Martín-Algarra S, Fernández-Figueras MT, López-Martín JA, Santos-Briz A, Arance A, Lozano MD, Berrocal A, Ríos-Martín JJ, Espinosa E, Rodríguez-Peralto JL. Guidelines for biomarker testing in metastatic melanoma: a National Consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology. Clin Transl Oncol 2013; 16:362-73. [DOI: 10.1007/s12094-013-1090-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 07/16/2013] [Indexed: 12/19/2022]
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Fleming JL, Dworkin AM, Allain DC, Fernandez S, Wei L, Peters SB, Iwenofu OH, Ridd K, Bastian BC, Toland AE. Allele-specific imbalance mapping identifies HDAC9 as a candidate gene for cutaneous squamous cell carcinoma. Int J Cancer 2013; 134:244-8. [PMID: 23784969 DOI: 10.1002/ijc.28339] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/07/2013] [Accepted: 05/31/2013] [Indexed: 12/21/2022]
Abstract
More than 3.5 million nonmelanoma skin cancers were treated in 2006; of these 700,000 were cutaneous squamous cell carcinomas (cSCCs). Despite clear environmental causes for cSCC, studies also suggest genetic risk factors. A cSCC susceptibility locus, Skts5, was identified on mouse chromosome 12 by linkage analysis. The orthologous locus to Skts5 in humans maps to 7p21 and 7q31. These loci show copy number increases in ∼10% of cSCC tumors. Here, we show that an additional 15-22% of tumors exhibit copy-neutral loss of heterozygosity. Furthermore, our previous data identified microsatellite markers on 7p21 and 7q31 that demonstrate preferential allelic imbalance (PAI) in cSCC tumors. On the basis of these results, we hypothesized that the human orthologous locus to Skts5 would house a gene important in human cSCC development and that tumors would demonstrate allele-specific somatic alterations. To test this hypothesis, we performed quantitative genotyping of 108 single nucleotide polymorphisms (SNPs) mapping to candidate genes at human SKTS5 in paired normal and tumor DNAs. Nine SNPs in HDAC9 (rs801540, rs1178108, rs1178112, rs1726610, rs10243618, rs11764116, rs1178355, rs10269422 and rs12540872) showed PAI in tumors. These data suggest that HDAC9 variants may be selected for during cSCC tumorigenesis.
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Affiliation(s)
- Jessica L Fleming
- Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University, Columbus, OH; The Ohio State University Comprehensive Cancer Center, Columbus, OH
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Yip BH, Moger TA, Pawitan Y. Genetic analysis of age-at-onset traits based on case-control family data. Stat Med 2011; 29:3258-66. [PMID: 21170919 DOI: 10.1002/sim.3907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Family studies are a useful alternative to twin studies for disentangling genetic and environmental effects on human diseases. However, although age-at-onset traits are often of interest, family-based quantitative genetic analysis of such data is still not commonly used. One reason is that we need multiple random components to capture the genetic and environmental contributions, so it becomes hard to use the existing frailty models for correlated survival data. In this paper we consider the alternative accelerated failure-time models with random effects. The method allows both left truncation and right censoring, and it can deal with an arbitrary family structure and multiple random components. For estimation we use the h-likelihood procedure, which avoids the integration of the random effects in the marginal likelihood approach. To deal with large cohort data, we propose a case-control scheme, where we ascertain all families with at least two events and a subsample of control families. A pseudo-h-likelihood approach is used to analyse the ascertained data. We study the performance of the method using simulated data, and provide an illustration with analysis of melanoma in the Swedish population.
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Affiliation(s)
- Benjamin H Yip
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong
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Frisell T, Lichtenstein P, Långström N. Violent crime runs in families: a total population study of 12.5 million individuals. Psychol Med 2011; 41:97-105. [PMID: 20334717 DOI: 10.1017/s0033291710000462] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Etiological theory and prior research with small or selected samples suggest that interpersonal violence clusters in families. However, the strength and pattern of this aggregation remains mostly unknown. METHOD We investigated all convictions for violent crime in Sweden 1973-2004 among more than 12.5 million individuals in the nationwide Multi-Generation Register, and compared rates of violent convictions among relatives of violent individuals with relatives of matched, non-violent controls, using a nested case-control design. RESULTS We found strong familial aggregation of interpersonal violence among first-degree relatives [e.g. odds ratio (OR)sibling 4.3, 95% confidence interval (CI) 4.2-4.3], lower for more distant relatives (e.g. OR cousin 1.9, 95% CI 1.9-1.9). Risk patterns across biological and adoptive relations provided evidence for both genetic and environmental influences on the development of violent behavior. Familial risks were stronger among women, in higher socio-economic strata, and for early onset interpersonal violence. There were crime-specific effects (e.g. OR sibling for arson 22.4, 95% CI 12.2-41.2), suggesting both general and subtype-specific familial risk factors for violent behavior. CONCLUSIONS The observed familiality should be accounted for in criminological research, applied violence risk assessment, and prevention efforts.
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Affiliation(s)
- T Frisell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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