载脂蛋白B和脂蛋白脂酶基因多态性与胃癌根治术后胆囊结石形成的关系

Relationship of gallstone formation after radical gastrectomy with the polymorphisms of apolipoprotein B Xba Ⅰ and lipoprotein lipase Hind Ⅲ gene

目的 探讨载脂蛋白B（ApoB）Xba Ⅰ位点和脂蛋白脂酶（LPL）HindⅢ位点的基因多态性与胃癌根治术后胆囊结石形成的关系.方法 选取复旦大学中山医院2006年诊断为胃癌的80例患者,采用聚合酶链反应-限制性片段长度多态性的方法检测每例患者ApoB Xba Ⅰ位点和LPL HindⅢ位点的基因型.比较这两个位点不同基因型患者术后2年胆囊结石形成情况.结果 本组患者失访8例.根据基因型检测结果,将72例患者分为X^＋X^-组（10例）和X^-X^-组（62例）,H^-组（27例）和H-缺失组（45例）.X^＋X^-组和X^-X^-组患者的胃癌术后胆囊结石的发生率分别为60.0%和6.5%,差异有统计学意义（P＜0.01）：X^＋X^-组患者手术前后血浆总胆固醇和低密度脂蛋白水平均明显高于X^-X^-组（P＜0.05）,而ApoB水平两组差异则无统计学意义（P＞0.05）.H^-组与H^-缺失组胃癌患者术后胆囊结石发生率分别为14.8%和13.3%.差异无统计学意义（P＞0.05）;H^-组血浆三酰甘油水平在手术前明显低于H^-缺失组（P＜0.05）,但术后两组差异无统计学意义（P＞0.05）.结论 ApoB Xba Ⅰ等位基因与胃癌根治术后患者的胆囊结石形成有关,而LPL HindⅢ等位基因则与其无关.

Objective To investigate the relationship of gallstone formation after radical gastrectomy with the polymorphisms of apolipoprotein B （ApoB） Xba Ⅰ gene and lipoprotein lipase（LPL） Hind Ⅲ gene.Methods A total of 80 gastric cancer patients who underwent radical gastrectomy at our hospital between January 2006 and December 2006 were divided into different groups according to the polymorphisms of ApoB Xba Ⅰ gene and LPL Hind Ⅲ gene.The gene polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism.Gallstone formation 2 years after radical gastrectomy was compared among different genotype groups.Results Eight patients were lost to follow-up.According to the genotype detection,72 patients were divided into X^＋X^- group（10 cases）,X^-X^-group（62 cases）,H^- group（27 cases） and H- deletion group（45 cases）.The incidence of gallstone was significantly higher in X^＋X^- group than that in X^-X^- group （60.0% vs 6.5%,P〈0.01）.The serum levels of total cholesterol TC and low density lipoprotein were significantly higher in X^＋X^- group than those in X^-X^- group （P〈0.05）,but the level of ApoB was not significantly different between the two groups.The incidence of gallstone was not significantly different between H^- group and H^- deletion group （14.8% vs 13.3%）.The level of triglyceride in H^- group was significantly lower than that in H^- deletion group before operation,however the difference disappeared after operation.Conclusion X^＋ allele may be associated with gallstone formation after radical gastrectomy,while H^- may not.