NR5A2 基因多态性与女性胃癌患者临床病理特征及预后的关系
| 作者: |
1张珣磊,
1宋丽,
2陈锦飞,
2汤翠菊,
1李剑英,
3龚伟达,
3谭永飞,
1杨磊
1 南通市肿瘤医院肿瘤内科，江苏 南通 226300 2 南京医科大学附属南京医院肿瘤内科，南京 210006 3 宜兴市肿瘤医院普外科，江苏 宜兴 214200 |
| 通讯: |
杨磊
Email: leiyang.53@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.06.012 |
| 基金: | 南通市卫生局青年科研基金 (WQ2015052)；南通市青年医学重点人才项目 ( 青年 005) |
摘要
目的：探讨NR5A2 rs3790843基因多态性与女性胃癌患者临床病理特征及预后的关系。方法：检测211例女性胃癌患者石蜡组织DNA上rs3790843基因多态性。采用Kaplan-Meier法、Log-rank检验及Cox回归分析NR5A2 rs3790843基因多态性对女性胃癌患者临床病理特征及预后的影响。 结果：非贲门癌组较贲门癌组能显著降低死亡风险，而有淋巴转移、远处转移、TNM分期较晚的患者，其死亡风险明显提高。在共显性模型中(TT vs TC vs CC)，携带TC基因型的患者相较与携带TT基因的患者，死亡风险明显降低(HR=0.616，95% CI 0.409~0.928)，在显性基因模型中(TT vs TC/CC)，携带TC/CC基因型的胃癌患者死亡风险相较携带TT基因型者，死亡风险明显降低(HR=0.619，95% CI 0.417~0.916，P=0.015)。而在隐性模型中(TT/TC vs CC)，携带TT/TC基因型的患者与携带CC基因型的患者的生存无显著差异。分层分析发现：在年龄≤60岁、非贲门癌、肿瘤>5 cm、有淋巴结转移、无远处转移、弥漫性胃癌、分化程度差、无术后辅助化疗、T4组、临床分期III期的分组中，rs3790843基因多态性能显著降低死亡风险。多因素Cox回归分析结果表明：有无淋巴结转移、肿瘤部位、rs3790843(TT vs TC/CC)均可作为影响女性胃癌患者的独立预后因子。结论：NR5A2 rs3790843 基因的T→C的突变能显著降低女性胃癌患者的死亡风险，是一个女性胃癌预后的保护性因素，可作为女性胃癌患者预后的独立预测指标。
关键词：
NR5A2 rs3790843；基因多态性；胃癌；女性
Association of NR5A2 gene polymorphisms with the clinicopathological characteristics and survival of female patients with gastric cancer
CorrespondingAuthor: YANG Lei Email: leiyang.53@163.com
DOI: 10.3978/j.issn.2095-6959.2018.06.012
Foundation: This work was supported by Youth Research Fund Project of the Health and Family Planning Commission of Nantong (WQ2015052), and the Project for Medical Key Youth Talent of Nantong (Youth 005)
Abstract
Objective: To study the relationship between the genetic polymorphism of NR5A2 rs3790843 and survival of female patients with gastric cancer. Methods: SNaPshot technology was performed in detecting the polymorphisms of rs3790843 from the genomic DNA of tumor specimens of the patients. NR5A2 rs3790843 was genotyped in 211 female gastric patients with surgical resection. The association between genotype and survival outcomes was performed by the Kaplan-Meier method, Cox regression analysis models and the log-rank test. Results: Patients in cardia cancer group had significantly higher risk of death compared with the non-cardia cancer group, and the patients with lymph node metastasis or distant metastasis or latter TNM stage had significantly higher risk of death than the others. In the codominant model and dominant model, patients with the TC or CC genotype had a significantly lower risk of death than that of patients with the TT genotype. No significant associations were observed in the recessive model. In the stratified analysis, rs3790843 polymorphism was associated with significantly lower risk of death in the groups of patients with younger than 60 years old, non-cardia cancer, tumor size >5 cm, lymph node metastasis, no distant metastasis, poorly differentiation, diffuse type, latter TNM stage, and no chemotherapy history. Cox stepwise regression analysis showed that lymph node metastasis, tumor location and rs3790843 SNP were independent prognostic factors for female GC. Conclusion: As a protective factor, NR5A2 rs3790843 variant C allele contributes to a better prognosis of female gastric cancer, which could be a potential prognostic and therapeutic marker.
Keywords：
NR5A2 rs3790843; single nucleotide polymorphism; gastric cancer; female