JNCI：端粒长度短的癌症患者生存期短

　　丹麦一项研究表明，端粒长度短与癌症患者生存期短相关，但与患癌风险无关。该研究论文3月6日在线发表于美国《国立癌症研究所杂志》（J Natl Cancer Inst）。

　　该研究是一项前瞻性研究，测量了47102名丹麦普通人群受试者的白细胞端粒长度，他们来自哥本哈根市心脏研究和哥本哈根普通人群研究。随访时间长达20年，以收集癌症诊断与死亡资料。随访完成率为100％。

　　结果显示，端粒长度随着年龄增长呈线性下降趋势（P＜0.001）。在随访过程中，研究观察到3142例首发癌症病例，其中1730例死亡。端粒长度缩短与癌症生存期缩短相关（对数秩检验P＜0.001）。校正多变量后，端粒短者癌症早期死亡风险升高，但患癌风险未出现这一趋势。

Short Telomere Length, Cancer Survival, and Cancer Risk in 47102 Individuals

Background:

Recent meta-analyses have suggested that short telomere length was associated with increased risk of cancer. We therefore tested the hypotheses that short telomere length was associated with increased risk of cancer and with increased risk of early death after cancer.

Methods:

We measured leukocyte telomere length in a prospective study of 47 102 Danish general population participants from the Copenhagen City Heart Study and the Copenhagen General Population Study. Participants were followed for up to 20 years for cancer diagnosis and death. Follow-up was 100% complete. All statistical tests were two-sided.

Results:

Telomere length decreased linearly with increasing age (P <.001). During follow-up, we observed 3142 first cancers and, among these individuals, 1730 deaths. Decreasing quartiles of telomere length were associated with decreasing survival after cancer (log-rank P <.001). Multivariable-adjusted hazard ratios of early death were 1.31 (95% confidence interval [CI] = 1.14 to 1.52) in individuals in the quartile and 1.43 (95% CI = 1.13 to 1.80) in individuals in the decile with the shortest telomeres vs the longest. Unadjusted hazard ratios of cancer risk were 1.74 (95% CI = 1.58 to 1.93) and 2.00 (95% CI = 1.70 to 2.35) in individuals in the quartile and decile with the shortest vs longest telomeres; however, multivariable adjustment changed these hazard ratios to 0.98 (95% CI = 0.88 to 1.08) and 0.95 (95% CI = 0.80 to 1.11), mainly because of age adjustment.

Conclusions:

Short telomere length is associated with reduced survival after cancer but not with cancer risk. The latter contrasts with findings from recent meta-analyses.