卵巢癌化疗感染危险因素及ESR2基因多态性与预后的关系

Risk factors for chemotherapy infection in ovarian cancer patients and correlation between ESR2 gene polymorphism and prognosis

目的探讨ESR2基因多态性与卵巢癌患者预后的关系及化疗感染危险因素分析。方法选择运城护理职业学院附属医院2016年5月-2018年5月卵巢上皮癌患者130例作为研究对象,根据预后情况分为预后不良组(n=52)及预后良好组(n=78),提取患者全血中DNA后,采用Sanger测序法对ESR2基因rs3020450位点多态性进行检测;采用Log-rank法分析不同基因型患者预后情况;调查患者病历并收集一般资料,采用多元Logistic分析患者在化疗期间发生感染的危险因素。结果两组患者ESR2基因rs3020450位点多态性基因型分布符合Hardy-Weinberg平衡;预后不良组AA基因型、A等位基因频率高于预后良好组(P<0.05);校正年龄、疾病分期绝经状态等因素后,混杂Logistic分析结果显示,以GG基因型为参考,AA基因型校正OR为1.39,95%CI值为1.194~1.665;Kaplan-Meier生存曲线结果表明,ESR2基因rs3020450位点携带AG+AA基因型的卵巢癌患者在随访期间无进展生存期低于携带GG基因型的卵巢癌患者(P<0.05);多元Logistic分析结果显示,年龄>60岁、营养指数评分>4分、合并基础性疾病、留置导尿管时间>7 d、住院时间>2周、合并放化疗是卵巢癌患者化疗期间发生感染的独立危险因素(P<0.05)。结论ESR2基因rs3020450位点携带AG+AA基因型患者预后往往较差,可作为风险评估的指标之一,在临床中应对存在化疗感染危险因素的患者加以针对性干预,以期改善预后。

OBJECTIVE To explore the relationship between ESR2 gene polymorphism and the prognosis of patients with ovarian cancer and analysis of risk factors for chemotherapy infection.METHODS A total of 130 patients with epithelial ovarian cancer from the Affiliated Hospital of Yuncheng Vocational College of Nursing from May 2016 to May 2018 were recruited as the research subjects.They were divided into the poor prognosis group(n=52)and good prognosis group(n=78)according to the prognosis.After extracting DNA from the whole blood of patients,we used the Sanger sequencing method to detect the polymorphism of the rs3020450 locus of ESR2 gene.The prognosis of patients with different genotypes was analyzed by Log-rank method;the patient’s medical records were investigated and general data were collected,and multivariate logistic analysis was used to analyze risk factors for infection in patients during chemotherapy.RESULTS The polymorphism genotype distribution of ESR2 rs3020450 locus in the two groups was in Hardy-Weinberg equilibrium.The frequency of AA genotype and A allele in the poor prognosis group was significantly higher than that in the good prognosis group(P<0.05).After adjusting for age,disease staging and menopause,mixed Logistic analysis showed that the corrected OR of AG+AA genotype was 1.39,and the 95%CI value was 1.194~1.665.Kaplan-Meier survival curve results showed that the progression-free survival time in patients carrying AG+AA genotype at tESR2 rs3020450 gene site during the follow-up period were significantly lower than those carrying GG genotype(P<0.05).Multivariate Logistic analysis showed that age>60 years,nutrition Index score>4 points,complicated underlying disease,indwelling catheter time>7 d,hospitalization time>2 weeks,combination of radiochemotherapy were independent risk factors for infection in ovarian cancer patients(P<0.05).CONCLUSION Patients with AG+AA genotype at the rs3020450 locus of ESR2 gene tend to have poor prognosis,which can be used as one of the risk assessment indicators.Targeted intervention should be carried out in patients with risk factors of chemotherapy infection in clinical practice,in order to improve the prognosis.