The impact of germline genetic variations in hydroxysteroid (17-beta) dehydrogenases on prostate cancer outcomes after prostatectomy

Eur Urol. 2012 Jul;62(1):88-96. doi: 10.1016/j.eururo.2011.12.021. Epub 2011 Dec 21.

Abstract

Background: The relationship between polymorphisms in the hydroxysteroid (17-beta) dehydrogenase (HSD17B) family of genes, which are involved in steroid hormone biotransformation, and the risk of prostate cancer (PCa) progression remains unexplored.

Objective: Determine whether inherited variations in HSD17B genes are associated with PCa progression.

Design, setting, and participants: We studied two independent Caucasian cohorts composed of 526 men with organ-confined PCa and 213 men with advanced disease who had a median follow-up of 7.4 yr and 7.8 yr after surgery, respectively.

Measurements: Patients with localised PCa were genotyped for 88 haplotype-tagging single nucleotide polymorphisms in HSD17B type 1 (HSD17B1), type 2 (HSD17B2), type 3 (HSD17B3), type 4 (HSD17B4), type 5 (HSD17B5), and type 12 (HSD17B12), and their prognostic significance on disease progression was assessed using Kaplan-Meier survival curves and Cox regression models. Positive findings were then investigated in advanced disease.

Results and limitations: After adjusting for known risk factors, 12 SNPs distributed across HSD17B2, HSD17B3, and HSD17B12 were significantly associated with risk of biochemical recurrence (BCR) in localised PCa (for variants in HSD17B2: hazard ratio [HR]: 1.92-2.93; p=0.025-0.004). In addition, four variants of HSD17B2 (rs1364287, rs2955162, rs1119933, rs9934209) were significantly associated with progression-free survival (HR: 2.96-4.69; p=0.004-0.00005) and overall survival in advanced disease (HR: 3.98-8.14; p=0.003-0.00002). Four variants of HSD17B3 and HSD17B12 were associated with a reduced risk of BCR (HR: 0.51-0.65; p=0.020-0.036) but not with progression in advanced disease. These results were generated mainly in Caucasians and should be studied in other ethnic groups.

Conclusions: This study suggests a prominent role for common genetic variants in the HSD17B2 pathway in PCa progression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 17-Hydroxysteroid Dehydrogenases / genetics*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Disease Progression
  • Disease-Free Survival
  • Haplotypes
  • Humans
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Prostate-Specific Antigen / blood
  • Prostatectomy
  • Prostatic Neoplasms / genetics
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / surgery*
  • Spermatozoa / enzymology
  • Treatment Outcome

Substances

  • 17-Hydroxysteroid Dehydrogenases
  • Prostate-Specific Antigen