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Yun Zhu,
Hao Wu,
Peizhong Peter Wang,
Sevtap Savas,
Jennifer Woodrow,
Tyler Wish,
Rong Jin, Roger Green,
Michael Woods,
Barbara Roebothan,
Sharon Buehler,
Elizabeth Dicks,
John R McLaughlin,
Peter T Campbell,
Patrick S Parfrey
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ABSTRACT: To examine the association between dietary patterns and colorectal cancer (CRC) survival.
Cohort study.
A familial CRC registry in Newfoundland.
529 newly diagnosed CRC patients from Newfoundland. They were recruited from 1999 to 2003 and followed up until April 2010.
Participants reported their dietary intake using a food frequency questionnaire. Dietary patterns were identified with factor analysis. Multivariable Cox proportional hazards models were employed to estimate HR and 95% CI for association of dietary patterns with CRC recurrence and death from all causes, after controlling for covariates.
Disease-free survival (DFS) among CRC patients was significantly worsened among patients with a high processed meat dietary pattern (the highest vs the lowest quartile HR 1.82, 95% CI 1.07 to 3.09). No associations were observed with the prudent vegetable or the high-sugar patterns and DFS. The association between the processed meat pattern and DFS was restricted to patients diagnosed with colon cancer (the highest vs the lowest quartile: HR 2.29, 95% CI 1.19 to 4.40) whereas the relationship between overall survival (OS) and this pattern was observed among patients with colon cancer only (the highest vs the lowest quartile: HR 2.13, 95% CI 1.03 to 4.43). Potential effect modification was noted for sex (p value for interaction 0.04, HR 3.85 for women and 1.22 for men).
The processed meat dietary pattern prior to diagnosis is associated with higher risk of tumour recurrence, metastasis and death among patients with CRC.
BMJ open. 01/2013; 3(2).
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Aung K Win,
Sean P Cleary,
James G Dowty,
Noralane M Lindor,
Polly A Newcomb,
Robert W Haile,
Joanne P Young,
Daniel D Buchanan,
Loïc Le Marchand, Roger Green,
John L Hopper,
Steven Gallinger,
Mark A Jenkins
Hereditary Cancer in Clinical Practice 05/2012; 9:1-1. · 1.68 Impact Factor
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ABSTRACT: Prognosis in colorectal cancer patients is quite variable, even after adjustment for clinical parameters such as disease stage and microsatellite instability status. It is possible that the psychological distress experienced by patients, including anxiety and depression, may be correlated with poor prognosis. In the present study, we hypothesize that genetic variations within three genes biologically linked to the stress response, namely serotonin transporter (SLC6A4), brain-derived neurotrophic factor (BDNF), and arginine vasopressin receptor (AVPR1B) genes are associated with prognosis in colorectal cancer patients. We used a population-based cohort of 280 patients who were followed for up to 12.5 years after diagnosis. Our multivariate analysis showed that a tagSNP in the SLC6A4 gene (rs12150214) was a predictor of shorter overall survival (HR: 1.572, 95%CI: 1.142-2.164, p = 0.005) independent of stage, age, grade and MSI status. Additionally, a multivariate analysis using the combined genotypes of three polymorphisms in this gene demonstrated that the presence of any of the minor alleles at these polymorphic loci was an independent predictor of both shorter overall survival (HR: 1.631, 95%CI: 1.190-2.236, p = 0.002) and shorter disease specific survival (HR: 1.691, 95%CI: 1.138-2.512, p = 0.009). The 5-HTT protein coded by the SLC6A4 gene has also been implicated in inflammation. While our results remain to be replicated in other patient cohorts, we suggest that the genetic variations in the SLC6A4 gene contribute to poor survival in colorectal cancer patients.
PLoS ONE 01/2012; 7(7):e38953. · 4.09 Impact Factor
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ABSTRACT: Identifying colorectal cancers (CRCs) with high levels of microsatellite instability (MSI-H) is clinically important. MSI-H is a positive prognostic marker for CRC, a predictive marker for resistance to standard 5-fluorouracil-based adjuvant chemotherapy, and an important feature for identifying individuals and families with Lynch syndrome. Our aim was to compare and improve upon the existing predictive pathology models for MSI-H CRCs. We tested 2 existing models used to predict MSI-H tumors, (1) Revised Bethesda Guidelines and (2) MsPath, in our population-based cohort of CRCs diagnosed less than 75 years from Newfoundland (N=710). We also scored additional histologic features not described in the other models. From this analysis, we developed a model for the prediction of MSI-H CRCs; Pathologic Role in Determination of Instability in Colorectal Tumors (PREDICT). An independent pathologist validated this model in a second cohort of all CRCs (N=276). Tumor histology was a better predictor of MSI status than was personal and family history of cancer. MsPath identified MSI-H CRCs with a sensitivity of 92.1% and a specificity of 37.8%, whereas the Revised Bethesda Guidelines had a sensitivity of 81.3% and a specificity of 39.5%. PREDICT included some new histology features, including peritumoral lymphocytic reaction and increased proportion of plasma cells in the tumor stroma. PREDICT was superior to both existing models in the development cohort with a sensitivity of 97.4% and a specificity of 53.9%. In the validation cohort, sensitivity was 96.9% and specificity 76.6%. We conclude that PREDICT is a good predictor of MSI-H CRC.
The American journal of surgical pathology 12/2010; 34(12):1820-9. · 4.06 Impact Factor
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Sean P Cleary,
Michelle Cotterchio,
Mark A Jenkins,
Hyeja Kim,
Robert Bristow, Roger Green,
Robert Haile,
John L Hopper,
Loic LeMarchand,
Noralane Lindor,
Patrick Parfrey,
John Potter,
Ban Younghusband,
Steven Gallinger
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ABSTRACT: The MutY human homologue (MYH) gene is a member of the base-excision repair pathway involved in the repair of oxidative DNA damage. The objective of this study was to determine colorectal cancer (CRC) risk associated with mutations in the MYH gene.
A total of 3811 CRC cases and 2802 controls collected from a multisite CRC registry were screened for 9 germline MYH mutations; subjects with any mutation underwent screening of the entire MYH gene. Logistic regression was used to estimate age- and sex-adjusted odds ratios (AOR). Clinicopathologic and epidemiologic data were reviewed to describe the phenotype associated with MYH mutation status and assess for potential confounding and effect modification.
Twenty-seven cases and 1 control subject carried homozygous or compound heterozygous MYH mutations (AOR, 18.1; 95% confidence interval, 2.5-132.7). CRC cases with homozygous/compound heterozygous mutations were younger at diagnosis (P=.01), had a higher proportion of right-sided (P=.01), synchronous cancers (P<.01), and personal history of adenomatous polyps (P=.003). Heterozygous MYH mutations were identified in 87 CRC cases and 43 controls; carriers were at increased risk of CRC (AOR, 1.48; 95% confidence interval, 1.02-2.16). There was a higher prevalence of low-frequency microsatellite instability (MSI) in tumors from heterozygous and homozygous/compound heterozygous MYH mutation carriers (P=.02); MSI status modified the CRC risk associated with heterozygous MYH mutations (P interaction<.001).
Homozygous/compound heterozygous MYH mutations account for less than 1% of CRC cases. Heterozygous carriers are at increased risk of CRC. Further studies are needed to understand the possible interaction between the base excision repair and low-frequency MSI pathways.
Gastroenterology 12/2008; 136(4):1251-60. · 11.68 Impact Factor
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Brent W Zanke,
Celia M T Greenwood,
Jagadish Rangrej,
Rafal Kustra,
Albert Tenesa,
Susan M Farrington,
James Prendergast,
Sylviane Olschwang,
Theodore Chiang,
Edgar Crowdy, [......],
Catherine Bonaiti-Pellié,
Bruno Buecher,
Elio Riboli,
Sebastien Kury,
Stephen J Chanock,
John Potter,
Gilles Thomas,
Steven Gallinger,
Thomas J Hudson,
Malcolm G Dunlop
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ABSTRACT: Using a multistage genetic association approach comprising 7,480 affected individuals and 7,779 controls, we identified markers in chromosomal region 8q24 associated with colorectal cancer. In stage 1, we genotyped 99,632 SNPs in 1,257 affected individuals and 1,336 controls from Ontario. In stages 2-4, we performed serial replication studies using 4,024 affected individuals and 4,042 controls from Seattle, Newfoundland and Scotland. We identified one locus on chromosome 8q24 and another on 9p24 having combined odds ratios (OR) for stages 1-4 of 1.18 (trend; P = 1.41 x 10(-8)) and 1.14 (trend; P = 1.32 x 10(-5)), respectively. Additional analyses in 2,199 affected individuals and 2,401 controls from France and Europe supported the association at the 8q24 locus (OR = 1.16, trend; 95% confidence interval (c.i.): 1.07-1.26; P = 5.05 x 10(-4)). A summary across all seven studies at the 8q24 locus was highly significant (OR = 1.17, c.i.: 1.12-1.23; P = 3.16 x 10(-11)). This locus has also been implicated in prostate cancer.
Nature Genetics 09/2007; 39(8):989-94. · 35.53 Impact Factor
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ABSTRACT: Case-control studies have successfully identified many genetic associations for complex diseases but suffer from lack of reproducibility in the same population. Demonstrating weak genetic effect requires large sample sizes to minimize statistical bias. Based on a study examining 500 myocardial infarction (MI) patients and 500 controls from the genetically isolated Newfoundland population, we previously reported that thrombospondin-4 (THBS-4) 1186G>C variant associates with MI in women. To validate this sex-dependent association with the THBS-4 variant, we analyzed an additional 532 patients and 514 controls from the same population and the combined cohort consisting of 1032 patients and 1014 controls.
Genotyping of THBS-4 1186G>C was conducted using Taq Man 1186G>C (A3879P) (rs 1866389) genotyping technology on real-time polymerase chain reaction.
The genotype distributions of THBS-4 1186G>C in the validation and combined cohorts were similar with those in our initial study, which supports genetic homogeneity in the studied population. The association of the CC genotype with MI in women (odds ratio [OR], 2.96; P = .008) reported in our initial cohort failed to achieve statistical significance in our validation cohort (OR, 1.53; P = .307) but was confirmed in the combined cohort (OR, 2.14; P = .009). In contrast to the results from the initial cohort was a significant association of the CC genotype with later onset MI in the validation (OR, 2.37; P = .029) and combined cohorts (OR, 2.22; P = .011). Moreover, the larger studied population gave statistical power to associate the CC genotype with risk of MI in the total patient population (OR, 1.58; P = .023).
Homozygosity for the THBS-4 1186C variant is a weak risk factor for MI especially in older women.
American heart journal 09/2006; 152(3):543.e1-5. · 4.65 Impact Factor
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Zhuoyu Sun,
Peizhong Peter Wang,
Barbara Roebothan,
Michelle Cotterchio, Roger Green,
Sharon Buehler,
Jinhui Zhao,
Josh Squires,
Jing Zhao,
Yun Zhu,
Elizabeth Dicks,
Peter T Campbell,
John R Mclaughlin,
Patrick S Parfrey
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ABSTRACT: Previous epidemiological studies have been suggestive but inconclusive in demonstrating inverse associations of calcium, vitamin D, dairy product intakes with risk of colorectal cancer (CRC). We conducted a large population-based comparison of such associations in Newfoundland and Labrador (NL) and Ontario (ON).
A case control study design was used. Colorectal cancer cases were new CRC patients aged 20-74 years. Controls were a sex and age-group matched random sample of the population in each province. 1760 cases and 2481 controls from NL and ON were analyzed. Information on dietary intake and lifestyle was collected using self-administered food frequency and personal history questionnaires.
Controls reported higher mean daily intakes of total calcium and total vitamin D than cases in both provinces. In ON, significant reduced CRC risk was associated with intakes of total calcium (OR of highest vs. lowest quintiles was 0.57, 95% CI 0.42-0.77, p(trend) = 0.03), total vitamin D (OR = 0.73, 95% CI 0.54-1.00), dietary calcium (OR = 0.76, 95% CI 0.60-0.97), dietary vitamin D (OR = 0.77, 95% CI 0.61-0.99), total dairy products and milk (OR = 0.78, 95% CI 0.60-1.00), calcium-containing supplements use (OR = 0.76). In NL, the inverse associations of calcium, vitamin D with CRC risk were most pronounced among calcium- or vitamin D-containing supplement users (OR = 0.67, 0.68, respectively).
Results of this study add to the evidence that total calcium, dietary calcium, total vitamin D, dietary vitamin D, calcium- or vitamin D-containing supplement use may reduce the risk of CRC. The inverse associations of CRC risk with intakes of total dairy products and milk may be largely due to calcium and vitamin D.
Canadian journal of public health. Revue canadienne de santé publique 102(5):382-9. · 1.02 Impact Factor
