中国北方汉族人群DNA修复能力的水平与头颈鳞癌发病风险的初步研究

A Preliminary Study for the Reduced DNA Repair Capacity in Lymphocytes and Risk of Head and Neck Squamous Cell Carcinoma in a Northern Chinese Population

目的:初步探讨北方汉族人DNA修复能力(DNA repair capacity,DRC)的水平与头颈鳞癌发病风险的相关性,为头颈鳞癌的诊断提供新的检测标志物。方法:收集71例头颈鳞癌患者和65例健康对照,均为我国北方地区汉族人。通过宿主细胞再活化(host cell reactivate,HCR)实验检测研究对象外周血淋巴细胞DRC的表达水平。对头颈鳞癌病例组和对照组之间一般特征的差异进行卡方检验,通过t检验及Wilcoxon秩和检验分析两组间DRC水平的差异。通过logistic回归模型计算优势比(OR值)及95%可信区间(95%CI)。此外,我们通过logistic模型计算ROC曲线下面积,进一步评价DRC模型的诊断价值。结果:头颈鳞癌组中DRC的水平在统计学上低于对照组(P=0.007)。在logistic回归模型分析中,矫正完年龄、性别、吸烟状况和饮酒因素后,DRC的水平与头颈鳞癌患病风险关系的ORs,在低水平与其DRC高水平相比为2.35(95%CI,1.11-4.98)。此外,DRC的水平降低与头颈鳞癌风险增加之间也存在剂量反应关系。最后,ROC曲线模型提示DRC模型中曲线下面积有所改善(P=0.068)。结论:北方汉族人中DRC水平的降低与头颈鳞癌发病风险的增加相关。本研究结果需在更大样本的后续研究中进一步验证。

Objective:To investigate the association between DNA repair capacity(DRC)and risk of head and neck squamous cell carcinoma o(HNSCC)in a northern Chinese population.Methods:The 71 HNSCC patients and 65 controls were recruited from northern part of China.The DRC levels were measured by host cell reactivate assay.The Chi-square test was used to evaluate differences in demographic variables between cases and controls.Student-t test and Wilcoxon rank-sum test were used to compare differences in the DRC levels.The associations of DRC levels with HNSCC risk were estimated by computing ORs and CIs from logistic regression analysis.To assess the improvement of HNSCC risk models,we compared the ROC curve among two risk models.Results:Compared with the controls,patients had lower expression levels of DRC(P=0.007).After dividing the subjects by controls’median of DRC levels,we found an association between an increased risk of HNSCC and low DRC levels[adjusted ORs and 95%CIs:2.35 and 1.11-4.98,Ptrend=0.026].When we assessed prediction models integrating demographic and clinical variables and DRC levels on HNSCC risk,the sensitivity of the expanded model was improved with the model including DRC levels.Conclusion:Reduced DRC levels were associated with an increased risk of HNSCC in a northern Chinese population.However,these results need to be validated in larger studies.