肺癌發(fā)病常見危險因素的臨床病例對照分析及XPD基因作用的初探
發(fā)布時間：2018-09-14 08:44
【摘要】：肺癌近幾年已成為嚴重危害人類健康的疾病,其死亡率在全球各國均上升顯著,在我國已躍居腫瘤死因首位。肺癌的預防及后續(xù)診治是當前極為重要的公共健康問題之一。流行病學研究報道了肺癌的幾種常見的危險因素,包括吸煙史,疾病史及易感基因,我們將從生活行為方式、精神心理因素、職業(yè)環(huán)境因素、飲食因素、既往有無呼吸系統(tǒng)疾病史及家族性腫瘤病史等方面入手進行分析總結,期望為肺癌的防控提供理論依據(jù)。同時本文還重點強調了易感基因的獨特作用,通過meta分析的方法更進一步分析肺癌易感基因與肺癌的關聯(lián)性。第一部分常見肺癌危險因素的病例對照分析目的:探討影響原發(fā)性肺癌的常見的危險因素,為闡明肺癌病因提供依據(jù)。方法:應用病例對照研究的方法,收集北京軍區(qū)總醫(yī)院2014-2016年收治的126例肺癌患者,對照118人,統(tǒng)一采用問卷調查方法,對所有入選人群的一般情況(性別、年齡、體質指數(shù))、生活行為方式(吸煙或被動吸煙情況、飲酒、飲茶、飲咖啡、熬夜)、精神心理因素、職業(yè)環(huán)境因素、飲食、既往有無呼吸系統(tǒng)疾病史及家族性腫瘤病史進行調查。所有結果均采用SPSS22.0統(tǒng)計軟件包分析。結果:有長期吸煙行為及暴露于被動吸煙環(huán)境中的患者患肺癌的風險性顯著增加,其OR值分別是1.341和1.196;不適當?shù)娘嬀菩袨榧伴L期睡眠不足患肺癌的風險增加1.828和2.04倍;經歷不和諧的婚姻、生活壓力大和長期精神壓抑的人群易患肺癌,情緒自我調節(jié)能力差或生活態(tài)度消極也可增加肺癌發(fā)生的風險,其OR值分別為3.581和1.613;與苯、石棉、金屬粉塵、煤塵和油煙燃料接觸增加肺癌患病的發(fā)生率;攝入較多的新鮮果蔬和魚肉,多食用大蒜等是肺癌的保護性因素,而進食過多腌漬食品則會增加3.073倍肺癌的患病風險;肺結核病史、COPD病史等肺部疾病與肺癌均存在統(tǒng)計學關聯(lián),有腫瘤家族史的研究對象患肺癌的風險增加10.049倍。結論:肺癌的發(fā)病與長期大量吸煙、被動吸煙、長期睡眠不足、生活態(tài)度消極悲觀、長期精神壓抑、接觸石棉、金屬粉塵、廚房燃料油煙、食用腌漬食品和長期慢性呼吸道疾病史(如肺結核、COPD疾病病史)等多種因素有關,因此應將特殊人群如將長期吸煙、精神壓力大、長期暴露于有害物質、慢性肺結核、COPD人群或有腫瘤家族史的人群作為預防肺癌的重點人群。第二部分XPD基因遺傳多態(tài)性與人群肺癌易感性關系的meta分析目的:DNA損傷修復基因XPD(Xeroderma Pigmentosum group D)參與核苷酸切除修復(Nucleotide Excision Repair,NER)過程,其單核苷酸多態(tài)性(SNP,single nucleotide polymorphism)的變異與肺癌易感性相關,因此本文通過meta分析的方法,系統(tǒng)評價核苷酸切除修復基因XPD多態(tài)性與肺癌的關聯(lián)。方法:檢索Pubmed、Embase、medline、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、萬方、維普、中國知網(CNKI)等中英文數(shù)據(jù)庫的相關文獻,檢索時間設定為從建庫至2016年3月,按照擬定的標準進行篩選。文獻主要涉及ERCC2/XPD基因多態(tài)性Lys751Gln及Asp312Asn與肺癌易感性關系的病例對照研究。用Revman 5.2對入組研究進行Meta分析,同時行亞組分析。結果:截止2016年3月1日符合條件的文獻共32篇,其中包含34項研究,累計病例數(shù)為19542人,對照組人數(shù)為25078人。Asn/Asn、Gln/Gln及Lys/Gln基因型攜帶者肺癌易感性明顯升高(p0.05),提示與肺癌的發(fā)生的易感性顯著相關。結論:ERCC2/XPD基因的單核苷酸多態(tài)性Asp312Asn和Lys751Gln作為肺癌發(fā)病的危險因素與肺癌易感性相關,尤其是等位基因Asn在亞洲人群中的作用、751Gln/Gln和751Lys/Gln基因在高加索及亞洲人群、醫(yī)院及社區(qū)人群的肺癌發(fā)病風險增加。
[Abstract]:Lung cancer has become a serious disease endangering human health in recent years. The mortality rate of lung cancer has risen remarkably in all countries of the world and has ranked first in China. Prevention and follow-up treatment of lung cancer is one of the most important public health problems. Epidemiological studies have reported several common risk factors of lung cancer, including smoking history. History of disease and susceptibility genes will be analyzed and summarized from aspects of lifestyle, psychosocial factors, occupational environment factors, dietary factors, past history of respiratory diseases and familial oncology in order to provide theoretical basis for the prevention and control of lung cancer. The association between lung cancer susceptibility genes and lung cancer was further analyzed by meta-analysis. Part I: Case-control analysis of common lung cancer risk factors Objective: To explore the common risk factors affecting primary lung cancer and provide evidence for elucidating the etiology of lung cancer. A total of 126 lung cancer patients admitted to our hospital from 2014 to 2016 were compared with 118 controls. Questionnaires were used to investigate the general situation (sex, age, body mass index), lifestyle (smoking or passive smoking, drinking alcohol, tea, coffee, staying up late), psychosocial factors, occupational environment, diet, and previous respiratory system of all the selected people. Results: Patients with long-term smoking and exposure to passive smoking had a significantly increased risk of lung cancer, with OR values of 1.341 and 1.196 respectively; those with inappropriate drinking and chronic sleep deprivation had a significantly increased risk of lung cancer. The OR value of lung cancer was 3.581 and 1.613 respectively, and exposure to benzene, asbestos, metal dust, coal dust and soot fuels increased the incidence of lung cancer. Increasing intake of fresh fruits, vegetables, fish and garlic was the protective factor for lung cancer, while eating too much pickled food increased the risk of lung cancer by 3.073 times. Pulmonary diseases such as tuberculosis, COPD and other lung diseases were statistically associated with lung cancer, with a 10.049-fold increase in the risk of lung cancer among subjects with a family history of cancer. Conclusion: The incidence of lung cancer is related to many factors, such as long-term smoking, passive smoking, long-term sleep deprivation, negative and pessimistic attitude towards life, long-term mental depression, exposure to asbestos, metal dust, cooking fumes, eating pickled food and long-term history of chronic respiratory diseases (such as tuberculosis, COPD) and so on. Long-term smoking, high mental stress, long-term exposure to harmful substances, chronic tuberculosis, COPD, or family history of cancer as the focus of the population to prevent lung cancer. Part II: XPD gene genetic polymorphisms and population susceptibility to lung cancer meta-analysis Objective: DNA damage repair gene XPD (Xeroderma Pigmentosum group D) involved in nuclear Nucleotide Excision Repair (NER) process, its single nucleotide polymorphism (SNP) mutation and lung cancer susceptibility related, so this paper through meta-analysis method, systematic evaluation of nucleotide excision repair gene XPD polymorphism and lung cancer association.Methods: Retrieve Pubmed, Embase, medline, in. Chinese and English databases, such as CBM, Wanfang, Weipu, CNKI, were selected according to the established criteria from the date of establishment to March 2016. The literature mainly involved case-control studies on the relationship between ERCC2/XPD gene polymorphism Lys751Gln and Asp312Asn and susceptibility to lung cancer. Results: As of March 1, 2016, there were 32 eligible literatures, including 34 studies, with a cumulative number of cases, and 25 078 controls. Asn/Asn, Gln/Gln and Lys/Gln genotype carriers were significantly more susceptible to lung cancer (p0.05). Conclusion: Single nucleotide polymorphisms of ERCC2/XPD gene Asp312Asn and Lys751Gln are associated with lung cancer susceptibility as risk factors for lung cancer, especially the role of allele Asn in Asian population, 751Gln/Gln and 751Lys/Gln genes in Caucasian and Asian populations, hospitals and community populations. The risk is increased.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R734.2
本文編號：2242171
[Abstract]:Lung cancer has become a serious disease endangering human health in recent years. The mortality rate of lung cancer has risen remarkably in all countries of the world and has ranked first in China. Prevention and follow-up treatment of lung cancer is one of the most important public health problems. Epidemiological studies have reported several common risk factors of lung cancer, including smoking history. History of disease and susceptibility genes will be analyzed and summarized from aspects of lifestyle, psychosocial factors, occupational environment factors, dietary factors, past history of respiratory diseases and familial oncology in order to provide theoretical basis for the prevention and control of lung cancer. The association between lung cancer susceptibility genes and lung cancer was further analyzed by meta-analysis. Part I: Case-control analysis of common lung cancer risk factors Objective: To explore the common risk factors affecting primary lung cancer and provide evidence for elucidating the etiology of lung cancer. A total of 126 lung cancer patients admitted to our hospital from 2014 to 2016 were compared with 118 controls. Questionnaires were used to investigate the general situation (sex, age, body mass index), lifestyle (smoking or passive smoking, drinking alcohol, tea, coffee, staying up late), psychosocial factors, occupational environment, diet, and previous respiratory system of all the selected people. Results: Patients with long-term smoking and exposure to passive smoking had a significantly increased risk of lung cancer, with OR values of 1.341 and 1.196 respectively; those with inappropriate drinking and chronic sleep deprivation had a significantly increased risk of lung cancer. The OR value of lung cancer was 3.581 and 1.613 respectively, and exposure to benzene, asbestos, metal dust, coal dust and soot fuels increased the incidence of lung cancer. Increasing intake of fresh fruits, vegetables, fish and garlic was the protective factor for lung cancer, while eating too much pickled food increased the risk of lung cancer by 3.073 times. Pulmonary diseases such as tuberculosis, COPD and other lung diseases were statistically associated with lung cancer, with a 10.049-fold increase in the risk of lung cancer among subjects with a family history of cancer. Conclusion: The incidence of lung cancer is related to many factors, such as long-term smoking, passive smoking, long-term sleep deprivation, negative and pessimistic attitude towards life, long-term mental depression, exposure to asbestos, metal dust, cooking fumes, eating pickled food and long-term history of chronic respiratory diseases (such as tuberculosis, COPD) and so on. Long-term smoking, high mental stress, long-term exposure to harmful substances, chronic tuberculosis, COPD, or family history of cancer as the focus of the population to prevent lung cancer. Part II: XPD gene genetic polymorphisms and population susceptibility to lung cancer meta-analysis Objective: DNA damage repair gene XPD (Xeroderma Pigmentosum group D) involved in nuclear Nucleotide Excision Repair (NER) process, its single nucleotide polymorphism (SNP) mutation and lung cancer susceptibility related, so this paper through meta-analysis method, systematic evaluation of nucleotide excision repair gene XPD polymorphism and lung cancer association.Methods: Retrieve Pubmed, Embase, medline, in. Chinese and English databases, such as CBM, Wanfang, Weipu, CNKI, were selected according to the established criteria from the date of establishment to March 2016. The literature mainly involved case-control studies on the relationship between ERCC2/XPD gene polymorphism Lys751Gln and Asp312Asn and susceptibility to lung cancer. Results: As of March 1, 2016, there were 32 eligible literatures, including 34 studies, with a cumulative number of cases, and 25 078 controls. Asn/Asn, Gln/Gln and Lys/Gln genotype carriers were significantly more susceptible to lung cancer (p0.05). Conclusion: Single nucleotide polymorphisms of ERCC2/XPD gene Asp312Asn and Lys751Gln are associated with lung cancer susceptibility as risk factors for lung cancer, especially the role of allele Asn in Asian population, 751Gln/Gln and 751Lys/Gln genes in Caucasian and Asian populations, hospitals and community populations. The risk is increased.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R734.2
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1 金珊珊;肺癌發(fā)病常見危險因素的臨床病例對照分析及XPD基因作用的初探[D];大連醫(yī)科大學;2016年
，本文編號：2242171
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