本文選題：瘦素受體　切入點：乳腺癌　出處：《江蘇大學(xué)》2017年碩士論文

【摘要】：目的:許多流行病學(xué)研究已經(jīng)發(fā)現(xiàn)瘦素與身體脂肪程度以及乳腺癌有關(guān)。瘦素通過瘦素受體(LEPR)發(fā)揮其生理作用受體。但是,目前已發(fā)表的關(guān)于LEPR與乳腺癌發(fā)生之間關(guān)系的數(shù)據(jù)仍充滿爭議。本研究采用系統(tǒng)評價方法分析已發(fā)表的相關(guān)文獻的相關(guān)數(shù)據(jù),來得出更準確的評估LEPR多態(tài)性與乳腺癌罹患風(fēng)險關(guān)系的結(jié)論,為乳腺癌的診治提供一定的指導(dǎo)。方法:本研究按照設(shè)定的關(guān)鍵詞檢索了Pub Med Central、ISI知識網(wǎng)、CNKI以及Embase數(shù)據(jù)庫等數(shù)據(jù)庫中從建庫至2012年04月20日發(fā)表的臨床研究。對符合納入標(biāo)準的研究進行資料提取后用Stata 10.0軟件進行數(shù)據(jù)分析。對LEPR多態(tài)性與乳腺癌罹患風(fēng)險關(guān)聯(lián)強度采用比值比(OR)及其95%可信區(qū)間(CI)描述。各研究間的異質(zhì)性采用Q檢驗及I2檢驗評價。當(dāng)各研究結(jié)果間異質(zhì)性較低時,采用固定效應(yīng)模型進行分析;否則則采用隨機效應(yīng)模型進行分析。異質(zhì)性分析采用亞組分析及敏感性分析。發(fā)表偏倚采用Begg漏斗圖以及Egger’s線性回歸分析,P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果:本Meta分析共納入10項LEPR rs1137101多態(tài)性研究,包括4644例病例組和5485例對照組的;共納入5項rs1137100多態(tài)性研究包括2759例病例組和4464例對照組以及納入2項rs8179183、rs4655537和rs3762274多態(tài)性研究。采用合并的比值比(OR)與95%置信區(qū)間(CI)估計乳腺癌風(fēng)險與LEPR基因型的相關(guān)性。當(dāng)所有研究合并后發(fā)現(xiàn)升高的乳腺癌風(fēng)險與LEPR相關(guān)rs1137101多態(tài)性有關(guān),(等位基因?qū)Ρ饶Ｐ?OR=0.71,95%CI=0.551-0.997)。在按種族分層分析后發(fā)現(xiàn),等位基因?qū)Ρ饶Ｐ?OR=0.414,95%CI=0.312-0.550)以及顯性模型(OR=0.537,95%CI=0.370-0.781)中亞洲人乳腺癌發(fā)生風(fēng)險顯著增加。對于非洲人,等位基因?qū)Ρ饶Ｐ?OR=0.716,95%CI=0.595-0.861)、純合子顯性模型(OR=0.537,95%CI=0.370-0.781)和顯性模型(OR=1.595,95%CI=1.207-2.108)中也發(fā)現(xiàn)乳腺癌發(fā)生風(fēng)險顯著增加。并且LEPR rs1137100多態(tài)性的等位基因?qū)Ρ饶Ｐ?OR=0.666,95%CI=0.603-0.720)和純合子共顯性模型(OR=0.344,95%CI=0.282-0.421)中乳腺癌發(fā)生風(fēng)險是增加的。對于LEPRrs8179183、rs4655537和rs3762274多態(tài)性,所有比較模型中都沒發(fā)現(xiàn)與乳腺癌發(fā)生風(fēng)險相關(guān)。結(jié)論:本研究發(fā)現(xiàn)rs1137101和rs1137100多態(tài)性與乳腺癌發(fā)生風(fēng)險顯著相關(guān),LEPR rs1137101變體的A等位基因和LEPR rs1137100變體的G等位基因是發(fā)生乳腺癌的低危因素。此外,LEPR rs8179183、rs4655537和rs3762274多態(tài)性和乳腺癌發(fā)生的風(fēng)險并沒有顯著的聯(lián)系。
[Abstract]:Objective: many epidemiological studies have found that leptin is associated with body fat levels and breast cancer. Leptin plays its physiological role through leptin receptor Lepr. The published data on the relationship between LEPR and breast cancer is still controversial. To arrive at a more accurate assessment of the association between LEPR polymorphism and breast cancer risk. Methods: in this study, we searched the database of Pub Med Central Pub and Embase database from the establishment of the database to 20 April, 2012, according to the key words set up in the diagnosis and treatment of breast cancer. The data were extracted and analyzed by Stata 10.0 software. The ratio of LEPR polymorphism to breast cancer risk was described by odds ratio (OR) and 95% confidence interval (CI). The heterogeneity of each study was analyzed. Q test and I2 test were used to evaluate. When the heterogeneity between the results of each study was low, The fixed effect model is used to analyze; Otherwise, random effect model was used. Heterogeneity analysis was based on subgroup analysis and sensitivity analysis. Publication bias was analyzed by Begg funnel graph and Egger's linear regression analysis (P0.05). Results: this Meta score was statistically significant. Ten LEPR rs1137101 polymorphisms were studied. Including 4644 cases and 5485 cases of control group; A total of 5 rs1137100 polymorphism studies were included, including 2759 cases and 4464 controls, as well as 2 rs8179183 rs4655537 and rs3762274 polymorphism studies. The association between breast cancer risk and LEPR genotype was estimated by using combined odds ratio (ORR) and 95% confidence interval (CI). Sex. When all studies were combined, increased breast cancer risk was found to be associated with LEPR associated rs1137101 polymorphisms (allelic comparison model: OR0.71, 95 CIQ 0.551-0.997). There was a significant increase in the risk of breast cancer in Asians in the allelic control model ORA 0.41495 CI 0.312-0.550) and the dominant model ORA 0.53795 CI0.370-0.781. for Africans, there was a significant increase in the risk of breast cancer. A significant increase in the risk of breast cancer was also found in OR1.595-0.861CII, OR0.53795 CIQ 0.370-0.781) and the dominant model OR1.595-95CI1.207-2.108. and the LEPR rs1137100 polymorphism allelic correlation model OR0.66695CIT 0.603-0.720) and the homozygous codominant model OR0.34495CIQ 0.282-0.421) were also found to have a significant increase in the risk of breast cancer. The risk of occurrence is increased. For LEPRrs8179183 rs4655537 and rs3762274 polymorphism, Conclusion: rs1137101 and rs1137100 polymorphisms were significantly associated with breast cancer risk by allele A of LEPR rs1137101 variant and G allele of LEPR rs1137100 variant were found in all comparative models. Conclusion: in this study, we found that the polymorphism of rs1137101 and rs1137100 was significantly associated with the risk of breast cancer and the G allele of the variant of LEPR rs1137100 was significantly associated with the risk of breast cancer. In addition, LEPR rs8179183 rs4655537 and rs3762274 polymorphism were not significantly associated with the risk of breast cancer.
【學(xué)位授予單位】：江蘇大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.9

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