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Leukocyte telomere length associates with nasopharyngeal carcinoma risk and survival in H ong K ong C hinese
Author(s) -
Ko Josephine MunYee,
Tsang Kay HiuKi,
Dai Wei,
Choi Sheyne Sta Ana,
Leong Merrin ManLong,
Ngan Roger KaiCheong,
Kwong Dora LaiWan,
Cheng Ashley,
Lee Anne WingMui,
Ng Wai Tong,
Tung Stewart,
Lee Victor HoFun,
Lam KaOn,
Chan Candy KingChi,
Lung Maria Li
Publication year - 2018
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31617
Subject(s) - nasopharyngeal carcinoma , hazard ratio , quartile , proportional hazards model , medicine , odds ratio , confidence interval , telomere , oncology , survival analysis , logistic regression , gastroenterology , biology , genetics , dna , radiation therapy
Telomere shortening occurs as an early event in tumorigenesis. The TERT‐CLPTM1L locus associates with nasopharyngeal carcinoma (NPC) risk. It remains unknown if leukocyte telomere length (LTL) associates with NPC risk and survival. The relative LTL (rLTL) was measured by quantitative‐PCR in 2,996 individuals comprised of 1,284 NPC cases and 1712 matched controls. The odds ratio (OR) and 95% confidence intervals (CI) were calculated by logistic regression. The hazard ratio (HR) and 95% CI were calculated by Cox regression for survival analysis with rLTL and other clinical parameters in 1,243 NPC with a minimum follow‐up period of 25 months. NPC patients had significantly shorter telomere length than controls. Shorter rLTL significantly associated with increased NPC risk, when the individuals were dichotomized into long and short telomeres based on median‐split rLTL in the control group (OR = 2.317; 95% CI = 1.989–2.700, p = 4.10 × 10 −27 ). We observed a significant dose–response association ( p trend = 3.26 × 10 −34 ) between rLTL and NPC risk with OR being 3.555 (95% CI = 2.853–4.429) for the individuals in the first quartile (shortest) compared with normal individuals in the fourth quartile (longest). A multivariate Cox regression analysis adjusted by age demonstrated an independent effect of rLTL on NPC survival for late‐stage NPC patients, when the individuals were categorized into suboptimal rLTL versus the medium rLTL based on a threshold set from normal (HR = 1.471, 95% CI = 1.056–2.048, p = 0.022). Shorter blood telomeres may be markers for higher susceptibility for NPC risk. Suboptimal rLTL may be a poor prognostic factor for advanced NPC patients, as it associates independently with poor survival.