新疆女性乳腺癌患者术后生命质量的调查以及外周血BRCA1基因甲基化的研究

发布时间：2018-05-03 21:06

本文选题：乳腺癌 + 术后生命质量　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:通过对新疆女性乳腺癌患者术后生命质量的调查和BRCA1基因甲基化程度的检测,了解患者预后的情况及其影响因素,探索外周血BRCA1基因甲基化在评价预后中的应用价值,为乳腺癌术后预后评价及康复指导提供依据。方法:采用面对面式访谈随访2011年至2012年入住新疆某肿瘤医院并继续来医院接受复查的192名原发乳腺癌患者(其中维吾尔族66名,汉族126名),填写乳腺癌患者生命质量专用量表(FACT-B),收集患者的临床资料、外周血样本并对血样的BRCA1基因甲基化情况进行焦磷酸测序检测。问卷相关内容使用描述性统计、t检验、方差分析、多元逐步回归分析,所得生物样本资料使用秩和检验、相关性检验使用Spearman秩相关分析。结果:本次调查中乳腺癌患者的生命质量总得分平均为84.33±16.5分,其中生理维度得分18.01±5.4分;社会?家庭维度得分17.18±4.02分;情感维度得分12.45±3.08分;功能维度得分16.48±4.52分;附加维度得分20.21±4.16分。单因素回归分析结果显示影响生命质量的总分和各维度的因素有:年龄、民族、文化程度、月收入、婚姻状况、有无复发转移、临床分期、医保状况,多元逐步回归分析结果显示:民族、年龄、临床分期、是否复发转移、月收入对生命质量总分影响较大;对外周血样本BRCA1基因启动区域的甲基化检测得出:术后5年发生复发转移的患者与未复发转移的患者在PM00064862区域的位点1、位点2、位点3与PM00064876区域的位点1、位点4甲基化率有统计学意义(P0.05);对复发转移患者在术前与术后5年的BRCA1基因甲基化率进行比较,PM00064862区域与PM00064876区域的甲基化率均无统计学意义;对未复发转移患者在术前与术后5年的BRCA1基因甲基化率进行比较,在PM00064862区域的位点1、位点3、位点4与PM00064876区域的位点1、位点2甲基化率有统计学意义(P0.05)。不同病理类型BRCA1基因甲基化程度在PM00064862区域的位点1、位点2、位点3、位点4与PM00064876区域的位点1的甲基化率有统计学意义(P0.05);以ER阴性阳性分组,BRCA1PM00064862位点1、位点3的甲基化率差异有统计学意义(P0.05);以PR阴性阳性分组,BRCA1PM00064862位点1、位点2、位点3的甲基化率差异有统计学意义(P0.05);以HER-2阴性阳性分组,在PM00064862区域位点1、位点3和在PM00064876区域位点1的甲基化率差异均有统计学意义(P0.05),三阴型与非三阴型在BRCA1PM00064862位点1与PM00064876位点1的甲基化程度差异均有统计学意义(P0.05)。BRCA1基因PM00064862区域位点1、位点2、位点3的甲基化程度与ER呈负相关,PM00064862区域位点1、位点2、位点3、位点4与PR呈负相关,BRCA1基因PM00064876区域位点1、位点2、位点3、位点4的甲基化程度与HER-2呈正相关。结论:民族、年龄、临床分期、是否复发转移、月收入对新疆地区女性乳腺癌术后生命质量的影响较大,外周血中BRCA1基因启动子区CpG岛甲基化的检测对乳腺癌的预后有一定的提示作用。
[Abstract]:Objective: to investigate the quality of life (QOL) and the degree of methylation of BRCA1 gene in female breast cancer patients in Xinjiang, and to explore the prognostic value of BRCA1 gene methylation in peripheral blood. To provide basis for postoperative prognosis evaluation and rehabilitation guidance of breast cancer. Methods: a total of 192 primary breast cancer patients (66 Uygur, including 66 Uygur) admitted to a tumor hospital in Xinjiang from 2011 to 2012 were followed up with face-to-face interviews. A total of 126 Han patients were enrolled in this study. The clinical data of patients with breast cancer were collected and the methylation of BRCA1 gene in blood samples was detected by pyrosequencing. Descriptive statistical t test, variance analysis, multiple stepwise regression analysis, rank sum test and Spearman rank correlation analysis were used in the related contents of the questionnaire. Results: the average score of quality of life of breast cancer patients was 84.33 卤16.5, and the score of physiological dimension was 18.01 卤5.4. Family dimension score 17.18 卤4.02, affective dimension 12.45 卤3.08, functional dimension 16.48 卤4.52, additional dimension 20.21 卤4.16. Univariate regression analysis showed that the total scores and dimensions of quality of life were: age, nationality, education, monthly income, marital status, recurrence and metastasis, clinical stage, medical insurance status. The results of multiple stepwise regression analysis showed that: nationality, age, clinical stage, recurrence and metastasis, monthly income had great influence on the total score of quality of life; Methylation of the priming region of BRCA1 gene in peripheral blood samples showed that the locus 1, locus 2, locus 3 and locus 1 and locus 4A of PM00064862 region were found in patients with recurrence and metastasis 5 years after operation and those without recurrence and metastasis. The methylation rate of BRCA1 gene in patients with recurrence and metastasis was not significantly higher than that in patients with recurrence and metastasis 5 years after operation (P < 0.05). There was no significant difference in methylation rate between PM00064862 region and PM00064876 region. The methylation rate of BRCA1 gene was compared between preoperative and postoperative 5 years in patients without recurrence and metastasis. The methylation rate of BRCA1 gene was significantly higher at locus 1, locus 3, locus 4, locus 1 and locus 2 in PM00064862 region than that in PM00064876 region (P 0.05). The methylation rate of BRCA1 gene in different pathological types was significantly higher than that in PM00064862 region (1, 2, 3, 4 and PM00064876), and the methylation rate of BRCA1PM00064862 and 3 was significantly higher than that of PM00064876. The methylation rate of BRCA1PM00064862 was significantly different from that of P0.05in PR negative group, and the methylation rate of BRCA1PM00064862 was significantly different from that of P0.05in HER-2 negative group. At PM00064862 locus 1, the methylation rates of locus 3 and PM00064876 locus 1 were significantly different (P 0.05). The methylation degree of BRCA1PM00064862 locus 1 and PM00064876 locus 1 was significantly different between the three negative type and non-trinegative type. There was significant difference in the methylation rate of BRCA1PM00064862 locus 1 and PM00064876 locus 1. BRCA1 gene PM00064862. The methylation degree of region locus 1, locus 2 and locus 3 was negatively correlated with ER, locus 1, locus 2, locus 3 and locus 4 were negatively correlated with PR of BRCA1 gene PM00064876 region locus 1, locus 2, locus 3, and locus 4 were positively correlated with HER-2. Conclusion: nationality, age, clinical stage, recurrence and metastasis, monthly income have great influence on the quality of life of female breast cancer patients in Xinjiang. The detection of CpG island methylation in the promoter region of BRCA1 gene in peripheral blood may indicate the prognosis of breast cancer.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

【相似文献】