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目的:评价雌激素受体α(estrogen receptorα,ERα)基因XbaⅠ酶切片段多态性(XbaⅠ多态性)、膳食大豆摄入与乳腺癌患病风险的关系。方法:采用病例对照研究设计,序贯收集病例对照各291例。采用问卷调查收集乳腺癌常见危险因素信息;采用频次调查及单次摄入量调查,收集膳食大豆类食物摄入情况,并转换为大豆异黄酮日摄入量。采用限制性片段长度多态性技术,检测XbaⅠ(rs9340799)A→G(x→X)基因突变。采用多因素Logistic回归分析XbaⅠ多态性、膳食大豆摄入的主效应和交互效应,并计算相乘交互系数。采用delta原理计算相加交互系数及其可信区间。结果:在总人群及绝经前后亚组中,携带X突变等位基因与乳腺癌患病风险无关(Xx vs.xx:OR=0.61~0.82;XX vs.xx:OR=0.60~3.62;Xx+XX vs.xx:OR=0.61~0.92,95%CI均包括1)。膳食大豆高摄入对乳腺癌具有保护作用(总人群:OR=0.64,95%CI:0.42~0.97;绝经后:OR=0.40,95%CI:0.19~0.81)。总人群中,携带X等位基因且膳食大豆高摄入进一步降低乳腺癌风险(OR=0.47,95%CI:0.25~0.89)。两者相乘交互系数IOR=1.15,95%CI:0.49~2.76;相加交互系数RERI=0.19,95%CI:-0.35~0.73;API=0.41,95%CI:-0.75~1.57;S=0.73,95%CI:0.34~1.59。结论:膳食大豆摄入可能会降低乳腺癌风险,但ERα基因XbaⅠ酶切片段多态性位点X等位基因与膳食大豆高摄入之间是否存在交互作用尚需进一步探讨。
Objective: To evaluate the relationship between Xba Ⅰ polymorphism of estrogen receptor α (ERα) gene and dietary soybeans and the risk of breast cancer. Methods: The case-control study design, sequential collection of 291 cases of each case control. A questionnaire was used to collect the information of common risk factors of breast cancer. Frequency and single-dose ingestion were used to collect dietary soy food intake and converted to daily soy isoflavone intake. The mutation of XbaⅠ (rs9340799) A → G (x → X) gene was detected by restriction fragment length polymorphism. Multivariate logistic regression analysis was used to analyze the main effects and interaction effects of Xba Ⅰ polymorphism and dietary soybeans intake and to calculate the multiplicative interaction coefficient. Using delta principle to calculate additive interaction coefficient and its confidence interval. Results: In the total population and the premenopausal and postmenopausal subgroups, the allele of X mutation was not associated with the risk of breast cancer (Xx vs.xx: OR = 0.61-0.82; XX vs.xx: OR = 0.60-3.62; XX vs.xx: OR = 0.61 ~ 0.92, 95% CI includes 1). High intake of dietary soy showed a protective effect on breast cancer (total population: OR = 0.64, 95% CI: 0.42-0.97; postmenopausal: OR = 0.40, 95% CI: 0.19-0.81). Of the general population, carrying the X allele with high dietary soybean intake further reduced the risk of breast cancer (OR = 0.47, 95% CI: 0.25-0.89). The interaction coefficient of the two was IOR = 1.15, 95% CI: 0.49 ~ 2.76; the additive interaction coefficient RERI = 0.19, 95% CI: -0.35 ~ 0.73; API = 0.41, 95% CI: -0.75 ~ 1.57; 0.73, 95% CI: 0.34 ~ 1.59. Conclusion: Ingestion of dietary soybeans may reduce the risk of breast cancer. However, it is necessary to investigate the interaction between X allele of Xba Ⅰ restriction site of ERα gene and dietary soybean high intake.