本文選題：維吾爾族　切入點(diǎn)：漢族　出處：《石河子大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:通過(guò)檢測(cè)新疆地區(qū)初診維吾爾族與漢族非小細(xì)胞肺腺癌外周血游離DNA中EGFR基因的表達(dá),探討兩民族間血清EGFR突變差異及其臨床特征特點(diǎn)。方法:收集116例就診于2015-05-01至2016-08-30石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院及喀什地區(qū)第一人民醫(yī)院,經(jīng)病理證實(shí)為非小細(xì)胞肺癌的患者,取靜脈血6ml按QIAamp Blood Mini Kit試劑盒提取血清游離DNA后。采用PCR及直接測(cè)序法檢測(cè)NSCLC患者外周血游離DNA中EGFR基因18、19、20、21號(hào)外顯子表達(dá)。統(tǒng)計(jì)學(xué)處理:采用SPSS 22.0統(tǒng)計(jì)軟件分析結(jié)果,患者一般資料、EGFR突變、EGFR及臨床特征之間的關(guān)系采用χ2檢驗(yàn),必要時(shí)用Fisher確切概率法,EGFR和臨床特征的多因素分析用logistic回歸分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.入組116例非小細(xì)胞肺癌血清標(biāo)本,包括70例漢族,46例維族,檢測(cè)出EGFR突變例數(shù)共23例,總突變率為19.8%。其中漢族突變例數(shù)19例,突變率27.1%,維吾爾族突變例數(shù)4例,突變率8.7%。可見(jiàn)非小細(xì)胞肺癌患者中維吾爾族突變率低于漢族突變率,有統(tǒng)計(jì)學(xué)差異(P=0.015)。2.所有檢測(cè)突變患者均為腺癌患者,其中漢族腺癌突變率36.5%(19/52),維吾爾族腺癌突變率13.3%(4/30),且有統(tǒng)計(jì)學(xué)差異(P=0.024)。3.檢測(cè)EGFR突變以19、21外顯子突變?yōu)橹�。維吾爾族患者19號(hào)外顯子所占比率75.0%(3/4)明顯高于21號(hào)外顯子所占比率25.0%(1/4),而漢族患者19號(hào)外顯子所占比率57.9%(11/19)略高于21號(hào)外顯子所占比率42.1%(8/19)。19、21突變率相比較,漢族與維族無(wú)統(tǒng)計(jì)學(xué)差異(P=0.406)。4.在漢族患者中,女性,不吸煙的患者EGFR基因突變率較高,有統(tǒng)計(jì)學(xué)差異(P0.05),而年齡、臨床分期和淋巴結(jié)轉(zhuǎn)移與EGFR突變無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。但在維族患者中,EGFR突變與性別、年齡、是否吸煙、臨床分期和淋巴結(jié)轉(zhuǎn)移無(wú)明顯關(guān)聯(lián)(P0.05)。5.Logistic多因素分析顯示,民族是EGFR基因突變的獨(dú)立影響因素,P0.05(95%CI區(qū)間:1.372-15.078)。而性別、年齡、是否吸煙和臨床分析對(duì)EGFR突變影響不明顯(P0.05)。結(jié)論:1.新疆漢族與維吾爾族非小細(xì)胞肺癌患者血清EGFR突變率有差異。2.新疆漢族非小細(xì)胞肺癌EGFR突變常見(jiàn)于女性、腺癌、不吸煙患者。3.新疆維吾爾族非小細(xì)胞肺癌EGFR突變常見(jiàn)于腺癌,且突變與性別、是否吸煙等臨床特征無(wú)明顯關(guān)聯(lián)。4.民族是血清EGFR突變的獨(dú)立影響因素。
[Abstract]:Objective: to detect the expression of EGFR gene in peripheral blood free DNA of newly diagnosed Uygur and Han non-small cell lung adenocarcinoma in Xinjiang. To explore the difference of serum EGFR mutation and its clinical characteristics between the two peoples. Methods: 116 patients with non-small cell lung cancer (NSCLC) were collected from the first affiliated Hospital of Shihezi University Medical College and the first people's Hospital of Kashi region from January 2015-01 to 2016-08-30. Serum free DNA was extracted from venous blood 6ml according to QIAamp Blood Mini Kit kit. PCR and direct sequencing were used to detect the expression of EGFR gene in peripheral blood of NSCLC patients. The relationship between EGFR mutation and clinical features was analyzed by 蠂 2 test. When necessary, the multivariate analysis of Fisher and clinical features by Fisher exact probability method and logistic regression analysis were statistically significant. Results: 1. Serum samples of 116 non-small cell lung cancer (NSCLC) patients, including 70 Han nationality (46 Uygur), were included in the study. 23 cases of EGFR mutation were detected, the total mutation rate was 19.80.There were 19 cases of Han nationality mutation, 27.1 cases of mutation rate, 4 cases of Uygur mutation, and 8.7% of mutation rate. It can be seen that the mutation rate of Uygur nationality is lower than that of Han nationality in non-small cell lung cancer patients. There was a statistical difference between the two groups. All the patients with mutation were adenocarcinoma. The mutation rate of adenocarcinoma of Han nationality was 36.5% / 52%, and the mutation rate of Uygur adenocarcinoma was 13.3%, and there was statistical difference between them. The detection of EGFR mutation was mainly in exon 1921. The percentage of exon 19 in Uygur patients was 75.0% higher than that in exon 21. The ratio of 25.0% to 1 / 4%, and the percentage of Han patients with exon 19 was 57.9% or 11 / 19), slightly higher than that of exon 21 (42.1% / 1921%). There was no statistical difference between Han nationality and Uygur nationality. The mutation rate of EGFR gene in female patients was higher than that in non-smoking patients (P 0.05). There was no significant difference between clinical stage and lymph node metastasis and EGFR mutation (P 0.05), but there was no significant correlation between EGFR mutation and sex, age, smoking, clinical stage and lymph node metastasis in Uygur nationality. Logistic multivariate analysis showed that there was no significant correlation between clinical stage and lymph node metastasis. Nationality is the independent factor influencing the mutation of EGFR gene P0.0595 CI: 1.372-15.0780.Sex, age, Smoking and clinical analysis had no significant effect on EGFR mutation. Conclusion 1.There is a significant difference in serum EGFR mutation rate between Xinjiang Han nationality and Uygur non-small cell lung cancer patients. 2.The EGFR mutation of Xinjiang Han nationality non-small cell lung cancer is more common than that of female and adenocarcinoma. Xinjiang Uygur non-small cell lung cancer EGFR mutation is common in adenocarcinoma, and mutation and sex, smoking and other clinical characteristics are not significantly related. 4. Nationality is an independent factor of serum EGFR mutation.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R734.2

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