饮食因素及血清中几种B族维生素含量与食管癌前病变关系的研究

发布时间：2018-05-10 23:26

本文选题：食管癌前病变 + 叶酸　；参考：《扬州大学》2013年硕士论文

【摘要】：目的：探讨江苏省淮安食管癌高发区食管癌前病变发生的影响因素,了解血清叶酸、VB2、VB6、VB12与食管癌前病变的关系,进一步探讨叶酸代谢酶MTR A2756G与食管癌前病变发生风险的关系,为将叶酸、VB2、VB6、VB12用于食管癌的预防和治疗以及为当地开展的食管癌防治工作提供科学依据,以达到降低食管癌的发病率和死亡率的目的。方法：(1)以食管癌高发区江苏淮安市淮安区为研究现场,依托卫生部食管癌早诊早治项目,采取整群抽样的方法抽取当地两个自然村40-69岁的高危人群进行流行病学问卷调查和胃内镜筛查。本研究对2011年筛查出的食管癌前病变人群和部分正常人群进行基本情况、疾病史、日常饮食史、家族史、吸烟史、饮酒史等对比分析研究,对食管癌前病变相关影响因素进行Logistic回归分析。(2)利用酶联免疫法测定两组人群血清叶酸、VB2、VB6、VB12水平,比较食管癌前病变组和正常对照组的差异,并将两组有显著性差异的维生素按正常对照组四分位数分为四个等级,估计血清维生素水平对食管癌前病变发生的危险度(OR)。(3)应用聚合酶链反应-限制性长度多态性(PCR-RFLP)方法检测两组人群MTR A2756G基因多态性,采用卡方检验分析食管癌前病变组和正常对照组MTR基因型分布的差异性。结果：(1)经非条件Logistic回归分析发现,进食速度快、喜食热烫食物、人年均收入低、消化系统疾病史可能是该地食管癌前病变的危险因素。(2)食管癌前病变组的血清叶酸水平明显低于正常组(P0.05),血清叶酸含量最高的四分者与含量最低的四分者相比其对食管癌前病变的OR值为0.348(95%CI：0.174-0.693),而食管癌前病变组的血清VB2、VB6、VB12水平与正常对照组无显著性差异。(3)食管癌前病变患者的MTR A2756G基因型和等位基因频率分布和正常对照组人群无显著性差异(P0.05),MTR基因多态性与食管癌前病变易感性未见统计学关联。结论：(1)进食速度快、喜食热烫食物、人年均收入低、既往消化系统疾病史可能是当地食管癌前病变主要的危险因素,可以通过改变当地的不良饮食习惯、膳食结构、生活方式等可变因素来预防食管癌前病变,并对有既往消化道系统疾病(包括有肿瘤家族史)的易感人群进行长期监测,以便早期发现,降低食管癌的发病率。(2)叶酸的缺乏可能是食管癌前病变的危险因素,可以通过摄入叶酸含量丰富的食物或适量维生素补充剂来预防食管癌前病变。(3) MTR A2756G基因多态性可能与食管癌前病变的风险无关。
[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.
【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R735.1;R155.1

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