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目的 探讨Ⅰ、Ⅱ相代谢酶中CYP1A1 ,GSTM1和GSTT1基因多态性与胃癌遗传易感性的关系 ,以及基因 基因、基因 环境之间的交互作用。方法 采用社区为基础的病例对照研究 ,代谢酶基因多态性的检测用PCR和PCR RFLP方法 ,资料分析用SAS软件进行多因素Logistic回归分析。研究对象 :1 997年 1月～ 1 998年 1 2月经扬中市人民医院确诊 ,肠型胃癌病例1 1 2例 ;同期该地无上消化道肿瘤的“健康”人群为对照 ,共 675例。结果 在调整了混杂因素后 ,仅GSTM 1缺失基因型与胃癌易感性有显著性相关 ,OR =1 95(CI:1 2 2 3 1 4 ) ;当GSTM 1和GSTT1同时缺失时 ,对胃癌发生的交互作用有显著性意义 ,OR =1 98,CI :1 0 2 3 85 ;未见CYP1A1突变基因与GSTM1或GSTT1缺失基因型对胃癌的发生有交互作用。在多因素Lo gistic回归分析中 ,也以GSTM1缺失基因型为最重要的遗传危险因素 ,胃癌家族史也有显著意义 ,环境危险因素主要包括 :既往吸烟史和既往饮酒史。同时发现CYP1A1和GSTM 1基因与吸烟、饮酒因素存在交互作用。结论 具有GSTM 1缺失或CYP1A1突变基因型的个体属胃癌高危险人群 ,在肿瘤防治方案中应加以注意
Objective To investigate the relationship between genetic polymorphisms of CYP1A1, GSTM1 and GSTT1 and the genetic susceptibility to gastric cancer and the interaction between gene and gene environment. Methods A community-based case-control study was carried out. The polymorphisms of metabolic enzymes were detected by PCR and PCR RFLP. The data were analyzed by SAS software using multivariate logistic regression analysis. PARTICIPANTS: From January 1997 to January 1998, 122 cases of intestinal-type gastric cancer were diagnosed in Yangzhong People’s Hospital and 675 cases of “healthy” people without upper gastrointestinal cancer in the same period. Results After adjusting the confounding factors, only the genotype of GSTM 1 deletion was significantly associated with the susceptibility to gastric cancer, OR = 1 95 (CI: 1 2 2 3 1 4). When GSTM 1 and GSTT 1 were simultaneously deleted, the occurrence of gastric cancer OR = 1 98, CI: 1 0 2 3 85; no interaction between CYP1A1 and GSTM1 or GSTT1 deletion genotypes was found in gastric cancer. In the multi-factor Lo gistic regression analysis, the genotype of GSTM1 deletion was the most important genetic risk factor, and the family history of gastric cancer was also significant. The environmental risk factors mainly included the history of previous smoking and the history of previous drinking. Also found that CYP1A1 and GSTM1 genes interact with smoking and drinking factors. Conclusion Individuals with GSTM 1 deletion or CYP1A1 mutation genotypes are at high risk for gastric cancer and should be noted in the prevention and treatment of cancer