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目的 探讨CYP1A1突变基因型与吸烟、饮酒因素对胃癌发生的交互作用及作用方式。方法 以社区为基础的病例对照研究 ,病例为胃镜及病理确诊的肠型胃癌 ,共 112例 ,以同期上消化道肿瘤病例的“健康”同胞、配偶和配偶的同胞为对照组 ,共 6 76例 ,用多聚酶链反应和限制性片段长度多态性法检测其基因型 ,多因素logistic回归模型分析与胃癌的相关性。结果 在调整混杂因素的影响后 ,未见CYP1A1突变基因型与胃癌危险性之间有统计学关联 ;但CYP1A1基因型与吸烟对胃癌发生有明显交互作用 ,显著增加胃癌的危险性 ,交互作用系数γ为 2 82 ,OReg值为 5 0 0 ,为 2型交互作用中的超相乘模型。进一步分析剂量反应关系显示 :突变基因型与吸烟量、开始吸烟年龄均呈“低暴露 基因效应”方式 ,即随着暴露剂量的增加 ,交互作用的强度逐渐降低。CYP1A1突变基因型与饮酒史的交互作用有减弱效应 ,OReg值为 2 2 2 ,γ为 0 46 ,但呈“高暴露 基因效应”。结论 CYP1A1突变基因型与吸烟、饮酒对胃癌均有交互作用 ,但交互作用的方式不同。这些结果提示CYP1A1突变基因型的个体应完全戒烟、限制大量饮酒 ,以预防胃癌的发生。
Objective To investigate the interaction of CYP1A1 mutant genotypes with smoking and drinking factors on the occurrence of gastric cancer and its mode of action. Methods A community-based case-control study consisted of 112 gastroscopic and pathologically confirmed bowel-type gastric cancers. A total of 6 76 healthy siblings, spouses, and spouses compatriots of the upper gastrointestinal cancer group were used as controls. Cases, using polymerase chain reaction and restriction fragment length polymorphism to detect their genotypes, multivariate logistic regression model to analyze the correlation with gastric cancer. Results After adjusting the influence of confounding factors, there was no statistical correlation between the CYP1A1 genotype and the risk of gastric cancer. However, the CYP1A1 genotype and smoking have a significant interaction with gastric cancer, significantly increased the risk of gastric cancer, and interaction coefficient. γ is 2 82 and OReg is 5 0 0 , which is an over-multiplication model in type 2 interaction. Further analysis of the dose-response relationship revealed that the mutant genotype, smoking volume, and age of initiation of smoking all showed a “low exposure gene effect” approach, ie, the intensity of interaction gradually decreased with increasing exposure dose. The interaction between the CYP1A1 mutant genotype and drinking history had a weakening effect, with an OReg value of 2 2 2 and γ of 0 46 , but a “high exposure gene effect”. Conclusion The CYP1A1 mutant genotypes interact with both gastric cancer and smoking, but their interactions are different. These results suggest that individuals with the CYP1A1 mutant genotype should completely quit smoking and limit heavy drinking in order to prevent the occurrence of gastric cancer.