乳腺癌患者血清中有机污染物浓度与疾病患病风险的研究

发布时间：2018-05-24 17:53

本文选题：乳腺癌 + 有机污染物　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:本实验研究目的在于检测大连地区女性乳腺癌患者与健康女性人群血清中含溴有机物PBDEs暴露水平,并根据暴露的浓度水平联系疾病其他相关危险因素,探索此类环境污染物在人体残留水平与乳腺癌发生的相关性,可以为疾病病因学研究和临床研究提供一定的参考。方法:本实验选取大连地区三级甲等医院2014年11月-2015年3月期间得到本院病理科确定诊断的女性原发性非特殊性浸润性乳腺癌病例60例,通过调查患者一般信息后,根据挑选的符合入组标准的患者信息,在同一医院选择一般信息基本匹配的健康女性60例作为对照组。在将研究的相关情况告知所选择的患者及健康人,获得本人同意和授权后,收集并记录实验所需信息,收集信息的内容包括:研究入组对象的一般情况、豆类及海鲜食品饮食习惯、月经史、既往疾病史以及家族史等相关资料。采集实验对象的晨起空腹血液标本,经过预处理血清样品后,通过气相色谱技术检测两组对象的血清中PBDEs和OH-PBDEs的暴露水平,再以检测到的有机物浓度在病例组和对照组之间比较。统计信息得到的乳腺癌相关危险因素运用卡方检验来分析。乳腺癌发病情况与血清样品中PBDEs和OH-PBDEs的暴露水平关系则用logistic回归统计分析。结果:(1)两组样品的血清中PBDEs和OH-PBDEs残留暴露水平的检测结果。PBDEs检出率:病例组和对照组分别为64-100%和57%-95%;OH-PBDEs检出率则为59-97%;56-90%,显示都具有很高的检出率。t检验统计分析两组差异,其中,病例组总PBDEs和OH-PBDEs都高于对照组的两者浓度(2)乳腺癌发病与PBDEs和OH-PBDEs残留暴露水平的危险度分析。其中病例组3-OH-BDE47、5-OH-BDE47、BDE-153和BDE-154的暴露率高于对照组并且同时差异有统计学意义(p0.05)。控制一般情况中的有关信息(年龄、BMI、生活习惯、居住地址),对检出的有机物进行单因素的Logistic回归分析,可以分析出其中部分成正相关。结论:本实验研究通过对大连地区乳腺癌女性患者及健康女性各60例进行血清中PBDEs和OH-PBDEs残留暴露水平的测定,并和相关危险因素比较分析得出如下结论:(1)所选取的两组对象体内PBDEs和OH-PBDEs检出率在患病女性及健康女性中都较高,认为大连地区女性人群整体处于PBDEs和OH-PBDEs的高暴露水平;(2)乳腺癌的发病与PBDEs和OH-PBDEs在体内残留暴露量有关,尤其是其中几种(包括3-OH-BDE47、5-OH-BDE47、BDE-47、BDE-154)呈明显正相关;即其暴露水平越高,患病的风险就越大;(3)针对生活环境中工业生产的污染物来探索研究乳腺癌发病因素,对临床医学和公共卫生事业治疗和预防乳腺癌有十分积极的作用。
[Abstract]:Objective: the aim of this study was to detect the PBDEs exposure level in serum of female breast cancer patients and healthy women in Dalian area, and to associate with other risk factors according to the exposure level. To explore the correlation between the residual level of environmental pollutants in human body and the occurrence of breast cancer can provide some references for etiology and clinical research. Methods: 60 cases of primary nonspecific invasive breast cancer from November 2014 to March 2015 in Dalian Grade 3A Hospital were selected. According to the selected patients' information, 60 healthy women with basic matched general information were selected as control group in the same hospital. After informing the selected patients and healthy persons of the relevant information of the study and obtaining the consent and authorization of the individual, the information needed for the experiment was collected and recorded. The information collected included: the general situation of the subjects involved in the study. Diet habits, menstrual history, past illness and family history of beans and seafood. Fasting blood samples were collected from the subjects in the morning. After pretreatment of serum samples, the exposure levels of PBDEs and OH-PBDEs in the serum of the two groups were detected by gas chromatography. The detected organic concentrations were compared between the case group and the control group. The risk factors associated with breast cancer obtained by statistical information were analyzed by chi-square test. The relationship between the incidence of breast cancer and the levels of PBDEs and OH-PBDEs in serum samples was analyzed by logistic regression. Results the detection rate of PBDEs and OH-PBDEs residual exposure levels in serum of the two groups were 64-100% and 57-9510% in the case group and the control group, respectively. The detectable rates of OH-PBDEs in the case group and the control group were 59-9775% and 56-90%, respectively. The results showed that there was a very high detection rate. T test was used to analyze the differences between the two groups. Total PBDEs and OH-PBDEs in the case group were higher than those in the control group (2) the risk of breast cancer incidence and residual exposure to PBDEs and OH-PBDEs was analyzed. The exposure rates of BDE-153 and BDE-154 of 3-OH-BDE47 and 5-OH-BDE47 in the case group were higher than those in the control group, and the difference was statistically significant (P 0.05). Control of general information (age BMI, living habits, residence address), the detection of organic matter by single factor Logistic regression analysis, can be found to be part of the positive correlation. Conclusion: in this study, serum PBDEs and OH-PBDEs residual exposure levels were measured in 60 women with breast cancer and 60 healthy women in Dalian area. Compared with the related risk factors, the following conclusions were drawn: the detection rates of PBDEs and OH-PBDEs in the two groups were higher in both healthy and diseased women. It is concluded that the incidence of breast cancer in Dalian area is closely related to the residual exposure of PBDEs and OH-PBDEs to PBDEs and OH-PBDEs, especially for several of them (including 3-OH-BDE47-OH-BDE47-BDE-47-BDE-154), that is, the higher the exposure level, the higher the risk of breast cancer. The higher the risk of breast cancer is, the greater the risk of breast cancer is. (3) to explore the risk factors of breast cancer in the light of industrial pollutants in living environment, it is very positive for clinical medicine and public health to treat and prevent breast cancer.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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