MTDH基因表达与乳腺癌痰湿证候相关性的研究

Study on the Correlation of MTDH Gene Expression with Phlegm-Damp Syndromes in Breast Cancer Patients

目的分析MTDH基因表达与乳腺癌痰湿证候群的相关性。方法选取2015年9月~2016年3月辽宁中医药大学附属第二医院收治的病理诊断明确为乳腺癌的80例患者,检测其外周血MTDH基因表达,探析MTDH基因表达与痰湿证候的相关性。应用K-均值聚类分析进行聚类,应用主成分分析,归纳出高贡献率症状因子及载荷,相关分析采用spearman法,诊断价值采用ROC曲线进行分析。结果患者共分为四类,第一类12例,主成分及因子分析结果如下:胸痛(0.747)、胸闷(0.727)、神疲乏力(0.707);第二类21例:腹泻(0.844)、食欲不振(0.789)、神疲乏力(0.728)、恶心呕吐(0.724);第三类13例:便秘(0.819)、口干舌燥(0.792)、食欲不振(0.781)、头晕耳鸣(0.746)、胸痛(0.701);第四类14例:畏寒(0.884)、腹泻(0.726)、腰膝酸软(0.725)。四类患者舌象分别为:舌淡红,苔薄,脉细弱;舌红,苔腻,脉弦滑;舌绛红或紫暗,少苔,脉沉细;舌质深红,苔剥脱,脉涩。参考中医证素和中医临床诊疗标准,第二类患者为痰湿证候群患者,spearson相关系数=0.903(P=0.002),呈中度相关。痰湿(+/-)证候群患者与MTDH基因表达情况:痰湿证候群患者△Ct值为(4.17±1.52),非痰湿证候群患者△Ct值为(6.92±1.86),差异有统计学意义(P<0.05),痰湿证候群患者MTDH基因表达是非痰湿证候群患者的6.727倍,痰湿证候与MTDH基因高表达具有相关性。痰湿证候群患者的MTDH基因高表达,曲线下面积为0.901,P=0.029,敏感度(Sensitivity)=0.857。痰湿证候群与转移相关性分析:曲线下面积0.760,P=0.001,敏感度(Sensitivity)=0.696。结论 MTDH基因高表达与痰湿证候群之间具有高度相关性(P<0.05);痰湿证候群患者与乳腺癌转移具有相关性(P<0.05)。

Objective To explore the correlation between metadherin(MTDH)gene expression and the phlegm-damp syndromes in breast cancer patients.Methods 80 cases of breast cancer patients with pathological diagnosis were selected in our research from the Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine between September 2015 and March 2016.We detected MTDH gene expression in peripheral blood of breast cancer patients,and explored the correlation between MTDH gene expression and phlegmdamp syndromes.The K-means cluster analysis was applied to cluster the data,and the principal component analysis was used to sum up the symptom factors and loads of high contribution rates.The Spearman method was used for correlation analysis,and ROC curve was used to analyze the diagnostic value.Results A total of 12 patients were classified in the first type,with the principal component analysis of chest pain(0.747),chest tightness(0.727),and fatigue(0.707).A total of 21 patients were classified in the second type,with the principal component analysis of diarrhea(0.844),appetite(0.789),fatigue(0.728).There were 18 patients in the third type,and the principal component analysis was constipation(0.819),dry mouth(0.792),loss of appetite(0.781),dizziness and tinnitus(0.746),chest pain(0.701).There were 14 patients in the fourth type,and the principal component analysis was fear of cold(0.884),diarrhea(0.726),lumbar debility(0.725).The tongue characteristics of four type patients had the following symptoms,thin tongue,red tongue coating,thin and weak pulse in the first type,red tongue and greasy tongue coating,thready and slippery pulse in the second type,red or purple tongue,dark purple tongue coating,and heavy fine pulse in the third type.Patients of the fourth type had deep red tongue,peeled-off tongue coating and astringent pulse.Patients of the second type had the phlegm-damp syndromes.The phlegm-damp syndromes patients had a highly correlation with MTDH gene expression,and the Spearson coefficient was 0.903(P=0.002).The delta Ct value of MTDH gene expression in patients with phlegm-damp syndromes was(4.17±1.52),and that in patients without phlegm-damp syndromes was(6.92±1.86).The MTDH gene expression in patients with phlegm-damp syndromes was 6.727 times of that in patients without phlegm-damp syndromes.It indicated that high MTDH gene expression had positive correlation with phlegm-damp syndromes.For analysis between phlegm-damp syndromes and MTDH gene expression,the ROC curve showed that area under the curve was 0.901,with P value of 0.029.The sensitivity was 0.857.For analysis between phlegmdamp syndromes and metastasis,area under the curve was 0.760,with P value of 0.001.The sensitivity was 0.696.Conclusion High MTDH gene expression had close correlation with phlegm-damp syndromes.The phlegm-damp syndromes had close correlation with metastasis in breast cancer patients.