小鼠双微体基因309T/G多态性及幽门螺杆菌感染与贲门癌的发病关联

Relation of MDM2 gene polymorphism and Helicobacter pylori infection to gastric cardiac carcinoma

目的通过比较贲门癌患者与匹配人群的幽门螺杆菌（（Helicobacter pylori，Hp）感染率和小鼠双微体基因（MDM2）309基因多态性，探讨MDM2309基因多态性及Hp感染与责门癌发病风险的关系。方法采用聚合酶链反应-限制性片段长度多态性方法，分析了106例贲门癌患者和性别、年龄配对的106例正常对照的MDM2—309基因型及其与贲门癌风险的相关性，实验对象胃镜取材进行活组织快速尿激酶检测（RUT）、活检组织病理染色和^14C尿素呼气试验（^14C-UBT），选其中任两种方法检测Hp结果一致者入选。结果贲门癌患者MDM2309基因G／G、G／T型分布频率高于对照组，OR值分别为3．02（95％ CI=1.38～6．59，P=0．009）、2．11（95％CI=1．07～4．15，P=0．031），在伴有Hp感染的贲门癌患者中，MDM2309基因G／6、G／T型与T／T型相比分布频率明显高于正常对照组（P〈0．05），OR值分别为5．38（95％CI=1．90～15．20，P=0．001）、3．20（95％CI=1．36～7．50，P=0．008），而HP阴性组中3种基因型分布频率差异无统计学意义。结论MDM2309G等位基因（G／G和G／T）可以增加贲门癌的发病风险，伴Hp感染后，MDM2309G等位基因携带者贲门癌发病风险显著提高。

Objective To investigate the association of MDM2 gene polymorphism and Helicobacter pylori（Hp） infection with gastric cardiac carcinoma（GCC） in matched Chinese population, and to study the correlation between MDM2 gene polymorphism and Hp infection and genetic susceptibilitis of GCC. Methods For 106 patients with GCC and 106 normal patients matched in gender and age,the polymorphism of MDM2 gene was studied by using polymerase chain reaction restriction fragment length polymorphism（PCR-RFLP） analysis, the infection of Hp was detected by rapid urease test（RUT）,histopathology and ^14C-urea breathtest（UBT）. Results The frequencies of MDM2 G/G and G/T genotype were higher in GCC than in normal controls, with odds ratio （ OR ） of 3.02 （95%CI=1. 38-6. 59, P = 0. 009）,2.11（95%CI=1. 07-4.15, P =0.031）, respectively. In GCC patients with Hp infections, the MDM2 G/G and G/T genotypes were higher than in normal controls（ P 〈0.05）, with OR of 5.38（95%CI= 1.90-15.20, P=0.001）,3.20（95%CI=1.36-7.50, P=0.008） respectively. However, in GCC patients without Hp infections, distributions of the MDM2 genotypes had no significant difference compared with those of normal controls. Conclusion MDM2-309 allelotype（G/G and G/T genotypes） may be associated with the high risk of OCC,and individuals with MDM2-309 allelotype have significantly higher risk of developing GCC in patients with Hp infection.