The RNASEL (encoding ribonuclease L) gene Glu265X mutation has been implicated in familial prostate cancer, and an association between the RNASEL Arg462Gln variant and sporadic and familial prostate cancer, has also been suggested. Because prostate cancer occurs in some familial pancreatic cancer families, we evaluated the role of the RNASEL gene variants Glu265X and Arg462Gln in the etiology of pancreatic cancer. Exon 2 of the RNASEL gene was directly sequenced in the germline of 36 familial and 75 sporadic pancreatic cancer patients and in 108 controls. The Glu265X mutation was identified in one (2.8%) familial and one (1.3%) sporadic pancreatic cancer case, but not in any of the controls. Arg462Gln variants were identified in 61 (56%) controls and in 55 (73%) sporadic pancreatic cancer cases with 8 (7%) and 12 (16%) homozygotes, respectively (p 5 0.009). For homozygous carriers the increased risk for pancreatic cancer was 3.5 (odds ratio [OR] 5 3.53, 95% confidence interval [CI] 5 1.11-11.46, p 5 0.03). The population attributable fraction (PAF) was 38.7% (95% CI 5 0.08-0.80). In familial pancreatic cancer no association between Arg462Gln genotypes and pancreatic cancer risk was evident. In sporadic pancreatic cancer there were no significant differences between Arg462Gln genotypes regarding clinical characteristics. In familial pancreatic cancer, however, patients with Arg462Gln variants had more aggressive tumors with more high grade cancers (OR 5 15.40, p 5 0.009) and more distant metastases (OR 5 7.00, p 5 0.04) than patients with the wild-type genotype. Our results suggest that RNASEL variants Glu265X and Arg462Gln may contribute to the tumorigenesis of sporadic and familial pancreatic cancer, which has to be proven in large scale studies. ' 2005 Wiley-Liss, Inc.Key words: RNASEL; familial pancreatic cancer; sporadic pancreatic cancer Pancreatic cancer (PC) is the fifth leading cause of cancer death in Western countries with an overall 5-year survival rate of <5%. 1 The genetic basis of pancreatic cancer is complex and seems to involve multiple susceptibility genes. Epidemiological data suggest that dominant susceptibility genes may be responsible for about 3% of all pancreatic cancer cases. 2,3 BRCA2 germline mutations have been identified in 4.9% and 7.3% of apparently sporadic PC cases 4,5 and about 17% of and familial pancreatic cancer (FPC) cases, 6,7 respectively. There is also some evidence that mutations in CDKN2a, PRSS1, Mismatch-Repair and Fanconi anaemia genes predispose to PC, but the contribution of these genes to PC tumorigenesis is considered to be small. 8 The major underlying gene defect(s) of FPC are still unknown.The RNASEL (2 0 -5 0 oligoisoadenylate-synthetase dependent) gene located at chromosome 1q24-q25 plays a causal role in cell death by viral and non-viral stimuli and represents an important fragment of the apoptosis cascade. 9 The role of the ''2 0 -5 0 A-system'' in the control of cellular growth suggests that defects in this pathway could result in reduced immunity to virus...