摘要
AIM： To investigate whether a fuzzy logic model could predict colorectal cancer （CRC） risk engendered by smoking in hereditary non-polyposis colorectal cancer （HNPCC） patients. METHODS： Three hundred and forty HNPCC mismatch repair （MMR） mutation carriers from the Creighton University Hereditary Cancer Institute Registry were selected for modeling. Age-dependent curves were generated to elucidate the joint effects between gene mutation （hMLH1 or hMSH2）, gender, and smoking status on the probability of developing CRC. RESULTS： Smoking significantly increased CRC risk in male hMSH2 mutation carriers （P 〈 0.05）. hMLH1 mutations augmented CRC risk relative to hMSH2 mutation carriers for males （P 〈 0.05）. Males had a significantly higher risk of CRC than females for hMLH1 non smokers （P 〈 0.05）, hMLH1 smokers （P 〈 0.1） and hMSH2 smokers （P 〈 0.1）. Smoking promoted CRC in a dose-dependent manner in hMSH2 in males （P 〈 0.05）. Females with hMSH2 mutations and both sexes with the hMLH1 groups only demonstrated a smoking effect after an extensive smoking history （P 〈 0.05）. CONCLUSION： CRC promotion by smoking in HNPCC patients is dependent on gene mutation, gender and age. These data demonstrate that fuzzy modeling may enable formulation of clinical risk scores, thereby allowing individualization of CRC prevention strategies.
瞄准：为了调查一个模糊逻辑模型是否能预言肤色，表面的癌症(CRC ) 风险由在世袭 non-polyposis 肤色吸表面的癌症(HNPCC ) 病人产生了。方法：从 Creighton 大学世袭癌症研究所登记的 340 个 HNPCC 失配修理(MMR ) 变化搬运人为当模特儿被选择。年龄依赖者曲线被产生阐明开发 CRC 的概率上的在基因变化(hMLH1 或 hMSH2 ) 之间的联合效果，性，和吸烟地位。结果：在男 hMSH2 变化搬运人的吸烟显著地增加的 CRC 风险(P < 0.05 ) 。hMLH1 变化为男性相对 hMSH2 变化搬运人扩充了 CRC 风险(P < 0.05 ) 。男性们非为 hMLH1 比女性有 CRC 的显著地更高的风险吸烟者(P < 0.05 ) ， hMLH1 吸烟者(P < 0.1 ) 并且 hMSH2 吸烟者(P < 0.1 ) 。以在在男性的 hMSH2 的一种剂量依赖者方式的吸烟支持的 CRC (P < 0.05 ) 。有 hMSH2 变化的女性和与 hMLH1 组一起的两性仅仅在广泛的吸烟历史以后表明了吸烟效果(P < 0.05 ) 。结论：由在 HNPCC 病人吸烟的 CRC 提升依赖于基因变化，性和年龄。这些数据证明模糊建模可以启用临床的风险分数的明确的表达，从而允许 CRC 预防策略的 individualization。
基金
Supported by a grant from the American College of Gastroenterology
