山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (1): 99-107.doi: 10.6040/j.issn.1671-7554.0.2024.0935
袁宗怀,潘广晔,迟曰梅,安传国,张永刚
YUAN Zonghuai, PAN Guangye, CHI Yuemei, AN Chuanguo, ZHANG Yonggang
摘要: 目的 探索低级别浆液性卵巢癌(low grade serous ovarian cancer, LGSOC)与乳腺癌(breast cancer, BC)的因果关系。 方法 采用双向两样本孟德尔随机化(mendelian randomization, MR)方法,使用公开的来自欧洲人群全基因组关联研究中的遗传数据,以单核苷酸多态性(single nucleotide polymorphisms, SNPs)作为工具变量,正向研究以LGSOC作为暴露变量、BC作为结局,反向研究以BC作为暴露变量、LGSOC为结局。另外对4种分子亚型BC进行亚组分析。运用逆方差加权(inverse variance weighted, IVW)、MR-Egger回归法、加权中位数、加权模型、简单模型来研究LGSOC和BC之间的因果关系。Cochrans Q检验工具变量的异质性。MR-Egger截距法检验水平多效性。 结果 正向研究纳入19个SNPs,MR分析结果显示,LGSOC与BC的风险增加存在正向因果关系(IVW:OR=1.05,95%CI:1.01~1.08, P=0.01)。亚组分析结果显示,LGSOC与雌激素受体(estrogen receptor, ER)阳性BC存在因果关系(P=0.07)。反向研究纳入95个SNPs,MR分析结果显示,BC与LGSOC的风险增加不存在因果关系(P>0.05)。异质性检验和多效性检验均未发现存在显著异质性和水平多效性(P>0.05)。 结论 欧洲人中LGSOC与BC的风险增加有正向因果关系,可能增加ER+ BC的发生风险,不支持BC与LGSOC风险增加的因果关系。
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