本文選題：食管癌前病變 + 葉酸��； 參考：《揚(yáng)州大學(xué)》2013年碩士論文

【摘要】：目的：探討江蘇省淮安食管癌高發(fā)區(qū)食管癌前病變發(fā)生的影響因素,了解血清葉酸、VB2、VB6、VB12與食管癌前病變的關(guān)系,進(jìn)一步探討葉酸代謝酶MTR A2756G與食管癌前病變發(fā)生風(fēng)險(xiǎn)的關(guān)系,為將葉酸、VB2、VB6、VB12用于食管癌的預(yù)防和治療以及為當(dāng)?shù)亻_(kāi)展的食管癌防治工作提供科學(xué)依據(jù),以達(dá)到降低食管癌的發(fā)病率和死亡率的目的。 方法：(1)以食管癌高發(fā)區(qū)江蘇淮安市淮安區(qū)為研究現(xiàn)場(chǎng),依托衛(wèi)生部食管癌早診早治項(xiàng)目,采取整群抽樣的方法抽取當(dāng)?shù)貎蓚�(gè)自然村40-69歲的高危人群進(jìn)行流行病學(xué)問(wèn)卷調(diào)查和胃內(nèi)鏡篩查。本研究對(duì)2011年篩查出的食管癌前病變?nèi)巳汉筒糠终Ｈ巳哼M(jìn)行基本情況、疾病史、日常飲食史、家族史、吸煙史、飲酒史等對(duì)比分析研究,對(duì)食管癌前病變相關(guān)影響因素進(jìn)行Logistic回歸分析。(2)利用酶聯(lián)免疫法測(cè)定兩組人群血清葉酸、VB2、VB6、VB12水平,比較食管癌前病變組和正常對(duì)照組的差異,并將兩組有顯著性差異的維生素按正常對(duì)照組四分位數(shù)分為四個(gè)等級(jí),估計(jì)血清維生素水平對(duì)食管癌前病變發(fā)生的危險(xiǎn)度(OR)。(3)應(yīng)用聚合酶鏈反應(yīng)-限制性長(zhǎng)度多態(tài)性(PCR-RFLP)方法檢測(cè)兩組人群MTR A2756G基因多態(tài)性,采用卡方檢驗(yàn)分析食管癌前病變組和正常對(duì)照組MTR基因型分布的差異性。 結(jié)果：(1)經(jīng)非條件Logistic回歸分析發(fā)現(xiàn),進(jìn)食速度快、喜食熱燙食物、人年均收入低、消化系統(tǒng)疾病史可能是該地食管癌前病變的危險(xiǎn)因素。(2)食管癌前病變組的血清葉酸水平明顯低于正常組(P0.05),血清葉酸含量最高的四分者與含量最低的四分者相比其對(duì)食管癌前病變的OR值為0.348(95%CI：0.174-0.693),而食管癌前病變組的血清VB2、VB6、VB12水平與正常對(duì)照組無(wú)顯著性差異。(3)食管癌前病變患者的MTR A2756G基因型和等位基因頻率分布和正常對(duì)照組人群無(wú)顯著性差異(P0.05),MTR基因多態(tài)性與食管癌前病變易感性未見(jiàn)統(tǒng)計(jì)學(xué)關(guān)聯(lián)。 結(jié)論：(1)進(jìn)食速度快、喜食熱燙食物、人年均收入低、既往消化系統(tǒng)疾病史可能是當(dāng)?shù)厥彻馨┣安∽冎饕奈ｋU(xiǎn)因素,可以通過(guò)改變當(dāng)?shù)氐牟涣硷嬍沉?xí)慣、膳食結(jié)構(gòu)、生活方式等可變因素來(lái)預(yù)防食管癌前病變,并對(duì)有既往消化道系統(tǒng)疾病(包括有腫瘤家族史)的易感人群進(jìn)行長(zhǎng)期監(jiān)測(cè),以便早期發(fā)現(xiàn),降低食管癌的發(fā)病率。(2)葉酸的缺乏可能是食管癌前病變的危險(xiǎn)因素,可以通過(guò)攝入葉酸含量豐富的食物或適量維生素補(bǔ)充劑來(lái)預(yù)防食管癌前病變。(3) MTR A2756G基因多態(tài)性可能與食管癌前病變的風(fēng)險(xiǎn)無(wú)關(guān)。
[Abstract]:Objective: to investigate the influencing factors of precancerous lesions in high incidence area of esophageal cancer in Huaian, Jiangsu Province, and to understand the relationship between serum folate VB2VB6VB12 and precancerous lesions, and to explore the relationship between folate metabolizing enzyme MTR A2756G and the risk of precancerous lesions. In order to provide scientific basis for the prevention and treatment of esophageal cancer and the prevention and treatment of esophageal cancer by using VB2VB6VB12 to reduce the morbidity and mortality of esophageal cancer. Methods taking Huaian District of Huaian City, Jiangsu Province, as the research site, relying on the early diagnosis and treatment project of esophageal cancer of the Ministry of Health, Cluster sampling was used to select high risk population aged 40-69 years from two local villages for epidemiological survey and gastric endoscopic screening. In this study, we compared and analyzed the basic condition, disease history, diet history, family history, smoking history, drinking history and so on. The levels of serum folate VB2VB6 and VB12 were measured by enzyme linked immunosorbent assay (Elisa), and the difference between the precancerous lesion group and the normal control group was compared. The vitamins of the two groups were divided into four grades according to the quartile of the normal control group. MTR A2756G gene polymorphism was detected by polymerase chain reaction-restriction length polymorphism (PCR-RFLP) method. The distribution of MTR genotypes in precancerous lesion group and normal control group was analyzed by chi-square test. Results (1) by non-conditional Logistic regression analysis, it was found that the average income of people was low because they ate fast and liked hot food. The history of digestive system disease may be the risk factor of esophageal precancerous lesion. (2) the serum folic acid level in the precancerous lesion group was significantly lower than that in the normal group (P 0.05), and the highest serum folic acid level was higher in the quartile group than that in the lowest one. The OR value for precancerous lesion was 0.34895 CI: 0.174-0.693.The serum VB2VB6VB12 level in precancerous lesion group was not significantly different from that in normal control group.) the distribution of MTR A2756G genotype and allele frequency in patients with precancerous lesion was similar to that in normal control group. There was no significant difference between P 0.05 MTR gene polymorphism and precancerous susceptibility to esophageal cancer. Conclusion 1) eating fast, eating hot food and eating hot food, people's average income is low. The history of digestive system disease may be the main risk factor of local esophageal precancerous lesion, which can be changed by changing local bad eating habits and dietary structure. Variable factors such as lifestyle are used to prevent precancerous lesions and long-term surveillance of susceptible populations with previous digestive tract diseases (including family history of cancer) for early detection. Reducing the incidence of esophageal cancer. 2) folic acid deficiency may be a risk factor for precancerous lesions. The polymorphism of MTR A2756G gene may not be associated with the risk of precancerous lesions of esophageal cancer by ingesting folic acid rich foods or vitamin supplements to prevent precancerous lesions.
【學(xué)位授予單位】：揚(yáng)州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R735.1;R155.1

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