李素霞,朱宏麗,郭 搏,楊 洋,王紅艷,孫敬芬,曹永彬
1解放軍總醫(yī)院 老年血液科,北京 100853;2解放軍總醫(yī)院 血液科,北京 100853;3解放軍總醫(yī)院第一附屬醫(yī)院 血液科,北京 100048
XPD基因多態(tài)性與非霍奇金淋巴瘤的相關(guān)性
李素霞1,朱宏麗1,郭 搏1,楊 洋1,王紅艷2,孫敬芬2,曹永彬3
1解放軍總醫(yī)院 老年血液科,北京 100853;2解放軍總醫(yī)院 血液科,北京 100853;3解放軍總醫(yī)院第一附屬醫(yī)院 血液科,北京 100048
目的探討核苷酸剪切修復(fù)基因-著色性干皮病基因D(Xeroderma pigmenting group D,XPD)單核苷酸多態(tài)性與非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)及其亞型發(fā)病風(fēng)險(xiǎn)的關(guān)系。方法選取解放軍總醫(yī)院、解放軍總醫(yī)院第一附屬醫(yī)院2011年3月- 2013年9月282例NHL患者和231例正常對(duì)照者為研究對(duì)象,采用SNaPshot方法檢測(cè)XPD的2個(gè)基因rs1799793、rs13181的基因多態(tài)性,分析其在NHL組和正常對(duì)照組中基因型和等位基因頻率分布的差異。采用Logistic回歸分析計(jì)算各個(gè)SNP的等位基因的比值比(odd ratio,OR)和95%置信區(qū)間(confidence interval,CI)。結(jié)果XPD rs1799793、rs13181在NHL組和正常對(duì)照組中基因型和等位基因頻率分布無(wú)統(tǒng)計(jì)學(xué)差異。XPD rs1799793、rs13181組合基因型在對(duì)照組和NHL組中無(wú)統(tǒng)計(jì)學(xué)差異。對(duì)NHL亞型分析顯示,與對(duì)照相比較,彌漫大B細(xì)胞性淋巴瘤、濾泡性淋巴瘤、T細(xì)胞性淋巴瘤、其他B細(xì)胞性淋巴瘤發(fā)病風(fēng)險(xiǎn)無(wú)差異。結(jié)論本組人群XPD rs1799793、rs13181基因多態(tài)性與NHL組及其亞型的發(fā)病無(wú)明顯相關(guān)性。
著色性干皮病基因D;非霍奇金淋巴瘤;單核苷酸多態(tài)性
非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)是一種常見(jiàn)的血液系統(tǒng)惡性腫瘤,其發(fā)病危險(xiǎn)因素除了病毒感染、大劑量輻射、接觸氯酚、苯、農(nóng)藥、服用某些免疫抑制劑導(dǎo)致免疫功能障礙等,遺傳易感性作用也日益突出。DNA損傷后個(gè)體修復(fù)能力的差異是決定遺傳易感性的主要因素。著色性干皮病基因D(xeroderma pigmenting group D,XPD)又被稱作切除修復(fù)交叉互補(bǔ)基因2(excision repair cross-complementing group 2,ERCC2),作為一種重要的DNA修復(fù)基因,在腫瘤研究中發(fā)現(xiàn)其基因多態(tài)性與多種腫瘤的易感性有關(guān)[1-6]。我們以病例對(duì)照方法,探討中國(guó)北方漢族人群XPD基因多態(tài)性與NHL患病風(fēng)險(xiǎn)的關(guān)系。
1 研究對(duì)象 非霍奇金淋巴瘤組患者為解放軍總醫(yī)院、解放軍總醫(yī)院第一附屬醫(yī)院血液科患者。鑒于種族因素影響,本研究對(duì)象選自2011年3月-2013年9月經(jīng)病理明確診斷的中國(guó)北方(長(zhǎng)江以北地區(qū))漢族NHL患者282例,其中男性203例,女性79例,平均年齡48.87歲。按照2008年淋巴組織腫瘤WHO新分類法,彌漫大B細(xì)胞淋巴瘤159例,T細(xì)胞性淋巴瘤52例,濾泡性淋巴瘤25例,其他B細(xì)胞性淋巴瘤46例。對(duì)照組為同期解放軍總醫(yī)院健康查體合格無(wú)腫瘤的中國(guó)北方漢族人群。
2 樣本采集 兩組均取外周靜脈血2 ml,EDTA抗凝,應(yīng)用Omega公司血標(biāo)本DNA提取試劑盒按照操作步驟提取DNA,于-20℃保存。
3 主要試劑及儀器 SNaPshot試劑盒(ABI PRISM?SNaPshotTMMulitiplex Kit,ABI公司),PCR純化試劑盒(ABI公司),Taq酶(TAKARA Taq Polymeras,TAKARA公司),凝膠成像儀(BioSens SC 810B,上海山富科學(xué)儀器有限公司),9700 PCR儀(ABI公司),3730XL測(cè)序儀(ABI公司)。
4 XPD基因rs1799793、rs13181基因型檢測(cè):1)引物設(shè)計(jì)合成:根據(jù)SNP位點(diǎn)序列信息,使用Primer5軟件設(shè)計(jì)擴(kuò)增引物和延伸引物并合成(表1)。2)預(yù)擴(kuò)增及純化:PCR預(yù)擴(kuò)增反應(yīng)體系為10 μl(包括10×緩沖液1.0 μl,dNTP混合物(2.5 mmol/L) 0.8 μl,HotstarR Taq DNA聚合酶(5 U/μl) 0.1 μl,PCR引物(32 mol/L)各0.2 μl和DNA模板(50 ng/μl)1 μl,擴(kuò)增程序?yàn)椋?5℃ 5 min、95℃ 30 s、53℃ 30 s、72℃ 30 s共35個(gè)循環(huán);72℃ 10 min。PCR擴(kuò)增后取反應(yīng)產(chǎn)物2 μl行瓊脂糖凝膠電泳進(jìn)行PCR產(chǎn)物質(zhì)檢。之后取PCR產(chǎn)物15 μl加入1 U CPI,37℃反應(yīng)1 h,75℃變性15 min進(jìn)行產(chǎn)物純化。3)延伸反應(yīng)及純化:取純化好的PCR產(chǎn)物、SNaPshot引物混合物、SNaPshot熒光混合物(含AmpliTaqDNA多聚酶和不同熒光標(biāo)記的ddNTP)組成一個(gè)PCR反應(yīng)體系。SNaPshot反應(yīng)程序?yàn)?6℃變性10 s,然后96℃變性10 s,53℃退火5 s,60℃延伸30 s,25個(gè)循環(huán)。之后60℃延伸30 s,4℃保存。延伸反應(yīng)產(chǎn)物10 μl加2.5 μl EDTA,18 μl無(wú)水乙醇,13 000 r/min,30 min,墊上吸水紙倒甩5 s,加入70%的冰乙醇,13 000 r/min,15 min,墊上吸水紙倒甩5 s,烘干10 min進(jìn)行純化。4)3730XL測(cè)序儀檢測(cè):將SNaPshot產(chǎn)物稀釋20倍.每份樣品中加入高純甲酰胺8.6 μl,分子內(nèi)標(biāo)0.9 μl,SNaPshot純化產(chǎn)物0.5 μl,總體積10 μl,95℃變性5 min,迅速冷凍4 min。在ABI3730XL型DNA序列檢測(cè)儀上進(jìn)行毛細(xì)管電泳,運(yùn)行Gene-Mapper4.0軟件分析實(shí)驗(yàn)結(jié)果。
5 統(tǒng)計(jì)學(xué)分析 采用擬合優(yōu)度χ2檢驗(yàn),計(jì)算基因型頻數(shù)分布是否符合Hardy-Weinberg平衡,檢驗(yàn)樣本的群體代表性;采用χ2檢驗(yàn)統(tǒng)計(jì)兩組間等位基因的頻率分布的差異,采用Logistic回歸分析計(jì)算各個(gè)SNP的等位基因以及各個(gè)突變組合基因型的比值比(odd ratio,OR)和95%置信區(qū)間(confidence interval,CI),統(tǒng)計(jì)分析用R統(tǒng)計(jì)軟件進(jìn)行。
表1 XPD基因SNP擴(kuò)增及延伸引物序列Tab. 1 XPD gene SNP amp lif cation p rimer and extension primer
1 兩組人口學(xué)特點(diǎn) 本研究病例組和對(duì)照組均選自中國(guó)北方漢族人群,231例對(duì)照組中男性138例(59.71%),女性93例(40.26%),年齡分布為13 ~87歲,平均年齡45.59歲。282例非霍奇金淋巴瘤組中男性203例(71.99%),女性79例(28.01%),年齡分布為12 ~ 89歲,平均年齡48.87歲,病例組和對(duì)照組年齡差異無(wú)統(tǒng)計(jì)學(xué)意義,性別差異有統(tǒng)計(jì)學(xué)意義。所有研究對(duì)象均知情同意并自愿參加。
2 XPD基因型及等位基因頻率分布 rs1799793、rs13181基因型分布在NHL組和正常對(duì)照組中均符合Hardy-Weinberg平衡(P>0.05),其基因型和等位基因頻率分布在兩組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。見(jiàn)表2。
3 XPD基因型分布與NHL亞型發(fā)病風(fēng)險(xiǎn)的相關(guān)性 將281例NHL患者分為彌漫大B細(xì)胞淋巴瘤、T細(xì)胞性淋巴瘤、濾泡性淋巴瘤和其他B細(xì)胞淋巴瘤4種亞型,結(jié)果表明,rs1799793、rs13181基因型分布在正常對(duì)照組與4種NHL亞型中無(wú)統(tǒng)計(jì)學(xué)差異。見(jiàn)表3。
4 XPD組合基因型與NHL及其亞型的相關(guān)性 將野生純合型基因型編碼為WT,突變純合型和雜合型基因型編碼為VT。XPD基因rs1799793、rs13181的4種組合基因型為WT-WT、WT-VT、VT-WT、VT-VT,以WT-WT為參考組合基因型,Logistic回歸計(jì)算其他3種組合基因的OR值和P值。結(jié)果顯示XPD的3種突變組合基因型在對(duì)照組和非霍奇金淋巴瘤組及其亞型組均無(wú)差異。見(jiàn)表4、表5。
表2 XPD rs1799793,rs13181 位點(diǎn)基因型和等位基因頻率分布Tab. 2 Genotype distributions and allele frequencies of exam ined polymorphism between cases and controls, as well as their prediction for NHL risk
表3 XPD 基因多態(tài)性與NHL及其亞型發(fā)病相關(guān)性Tab. 3 Genotype distributions of XPD exam ined polymorphism between cases and controls, as well as their prediction for NHL subtype risk
表4 XPD組合基因型與NHL發(fā)病相關(guān)性Tab. 4 Correlation between the combined XPD genotypes and risk of NHL (n,%)
隨著人類對(duì)疾病發(fā)生發(fā)展過(guò)程認(rèn)識(shí)的不斷加深,目前研究認(rèn)為,DNA修復(fù)基因多態(tài)性是決定機(jī)體腫瘤易感性的一個(gè)重要因素。著色性干皮病基因D位于19號(hào)染色體長(zhǎng)臂q13.3,由23個(gè)外顯子組成,編碼760個(gè)氨基酸。XPD蛋白是Ⅱ型轉(zhuǎn)錄因子H復(fù)合體的重要組成部分,涉及核苷酸切除修復(fù)(nucleotide excision repair,NER)和基因轉(zhuǎn)錄。作為一種重要的DNA修復(fù)基因,XPD基因突變減少其復(fù)合物的活性并引起修復(fù)和轉(zhuǎn)錄缺陷。研究顯示,XPD基因多態(tài)性與肺癌、食管癌、乳腺癌、胃癌等多種腫瘤的發(fā)生存在相關(guān)性[1-10]。
影響DNA修復(fù)基因單核苷酸多態(tài)性與腫瘤易感性關(guān)系的因素紛繁復(fù)雜,如不同DNA修復(fù)基因的多態(tài)性之間或同一DNA修復(fù)基因的不同多態(tài)性位點(diǎn)之間的交互作用、DNA修復(fù)基因的多態(tài)性與其他腫瘤相關(guān)基因的多態(tài)性之間的交互作用、接觸致癌物的類型、劑量、接觸方式和時(shí)間等、種族因素以及性別、年齡、生活習(xí)慣、內(nèi)分泌功能、營(yíng)養(yǎng)狀況等。本研究以中國(guó)北方漢族人群病例對(duì)照研究為基礎(chǔ),采用SNapShot聯(lián)合毛細(xì)管電泳的方法檢測(cè)了XPD rs1799793、rs13181基因多態(tài)性,比較不同基因型與NHL及其亞型發(fā)病風(fēng)險(xiǎn)的關(guān)系,同時(shí)對(duì)XPD rs1799793、rs13181這兩個(gè)不同多態(tài)性位點(diǎn)的組合基因型進(jìn)行了分析。結(jié)果顯示,rs1799793、rs13181基因多態(tài)性與NHL及其亞型的發(fā)病無(wú)明顯相關(guān)性,在進(jìn)一步的XPD rs1799793、rs13181突變組合基因型研究分析顯示,兩個(gè)不同多態(tài)性位點(diǎn)的突變組合基因型同樣與NHL及其亞型的發(fā)病無(wú)相關(guān)性。這與國(guó)外一些關(guān)于XPD與NHL的相關(guān)性研究結(jié)果一致[11-15]。與國(guó)內(nèi)宋寶等[16]對(duì)山東地區(qū)NHL患者研究XPD rs1799793、rs13181均與NHL或NHL亞型的發(fā)病無(wú)相關(guān)性的結(jié)果也一致。英國(guó)學(xué)者Worrillow等[17]研究了XPD rs13181、rs1799793、rs238406多態(tài)性與非霍奇金淋巴瘤的相關(guān)性,結(jié)果顯示上述基因多態(tài)性與非霍奇金淋巴瘤發(fā)病無(wú)相關(guān)性,但XPD rs13181 (Lys751Gln)Gln等位基因可以使彌漫大B細(xì)胞淋巴瘤的發(fā)病風(fēng)險(xiǎn)降低2倍(OR:0.56,95% CI:0.34 ~0.92,P=0.02)。
表5 XPD 組合基因型與NHL亞型發(fā)病相關(guān)性Tab. 5 Correlation between the combined XPD genotypes and risk of NHL subtypes
目前對(duì)于XPD的基因多態(tài)性與惡性血液系統(tǒng)腫瘤的發(fā)病風(fēng)險(xiǎn)、個(gè)體化治療、治療并發(fā)癥以及預(yù)后判斷的相關(guān)性也有研究[18-24]。如Monroy等[18]對(duì)200例霍奇金淋巴瘤(Hodgkin lymphoma,HL)患者的研究顯示XPD rs13181與HL的發(fā)病無(wú)相關(guān)性。而Storm等[19]對(duì)170例中危AML患者預(yù)后相關(guān)性的研究結(jié)果顯示XPD rs13181對(duì)中危急性髓系白血病(acute myeloid leukemia,AML)患者的總生存期有影響,rs13181帶有突變基因(AC/CC)組的AML患者生存期明顯短于野生型(AA)組患者(中位生存期22個(gè)月vs 40個(gè)月,P=0.03)。瑞金醫(yī)院Shi等[20]對(duì)15個(gè)基因的42個(gè)多態(tài)性位點(diǎn)與AML發(fā)病及預(yù)后的相關(guān)性研究,結(jié)果顯示XPD rs13181帶有突變的雜合子基因型增加AML的風(fēng)險(xiǎn)(OR:1.637;95% CI:1.118 ~ 2.395)。西班牙學(xué)者Cibeira等[21]研究了包括XPD rs13181在內(nèi)的15個(gè)不同基因的19個(gè)多態(tài)性位點(diǎn)與沙利度胺治療復(fù)發(fā)或難治多發(fā)性骨髓瘤患者的反應(yīng)率和生存期的相關(guān)性,結(jié)果顯示XPD rs13181與對(duì)藥物的反應(yīng)率和生存期無(wú)關(guān)。土耳其學(xué)者Ozdemir等[22]研究了XPD基因多態(tài)性與兒童白血病、淋巴瘤患者發(fā)生發(fā)熱性中性粒細(xì)胞減少癥、黏膜炎的相關(guān)性研究。該研究包括29例Brukitt淋巴瘤和61例急性淋巴細(xì)胞白血病兒童患者,結(jié)果顯示XPD rs13181、rs1799793基因多態(tài)性與上述疾病無(wú)關(guān)。此外還有少量的XPD基因多態(tài)性與繼發(fā)性AML預(yù)后、原發(fā)性血小板增多癥、真性紅細(xì)胞增多癥、骨髓纖維化出現(xiàn)白血病轉(zhuǎn)化的相關(guān)性研究[23-24]。
由于多種因素的影響,XPD基因多態(tài)性與多種血液系統(tǒng)疾病的相關(guān)性研究結(jié)果不同。本研究初期結(jié)果雖然顯示XPD rs13181、rs1799793與NHL的發(fā)病無(wú)明顯相關(guān)性,但由于樣本例數(shù)較少,今后的研究中將繼續(xù)擴(kuò)大研究范圍和研究對(duì)象,充分考慮這些影響因素,并進(jìn)行詳細(xì)分層研究,盡可能明確XPD基因單核苷酸多態(tài)性與NHL及其他血液系統(tǒng)惡性疾病易感性、疾病預(yù)后、治療并發(fā)癥之間的關(guān)聯(lián)。
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Correlation between XPD genetic polymorphism and non-Hodgkin's lymphoma
LI Su-xia1, ZHU Hong-li1, GUO Bo1, YANG Yang1, WANG Hong-yan2, SUN Jing-fen2, CAO Yong-bin3
1Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China;2Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China;3Department of Hematology, The First Aff liated Hospital of Chinese PLA General Hospital, Beijing 100048, China
Corresponding author: ZHU Hong-li. Email: bjzhl202@sina.com
ObjectiveTo explore the correlation between Xeroderma pigmenting group D (XPD)gene polymorphisms and non-Hodgkin lymphoma (NHL) risk.MethodsA case-control study with 282 non-Hodgkin lymphoma patients and 231 control subjects were conducted to investigate the role of two XPD gene polymorphisms (rs1799793, rs13181) on susceptibility to non-Hodgkin lymphoma by SNaPshot. A ll statistical analysis were done with R software. Genotype and allele frequencies of XPD were compared between patients and control group by chi-square test. Crude and adjusted odds ratios and 95% conf dence intervals were calculated by logistic regression based on genetic different models.ResultsThere was no signif cant difference between the control group and NHL or NHL subtype cases in genotype and variant genotype frequency. Analysis of XPD rs1799793, rs13181 showed that no combined genotype was associated with risk of NHL overall or four kinds of subtypes of NHL.ConclusionThere is no close relationship between XPD polymorphism (rs1799793, rs13181) and the risk of NHL or each histologic subtype of NHL.
xeroderma pigmenting group D; non-Hodgkin lymphoma; single nucleotide polymorphism
R 733.1
A
2095-5227(2014)08-0853-05
10.3969/j.issn.2095-5227.2014.08.022
2014-04-02 17:30
http://www.cnki.net/kcms/detail/11.3275.R.20140402.1730.001.html
2013-12-04
“重大新藥創(chuàng)制”科技重大專項(xiàng)(2008ZXJ09001-019);解放軍總醫(yī)院南樓青年創(chuàng)新基金(NQ201107)
Supported by “Major Country to Create a Special New Drugs”S&T Major Project(2008ZXJ09001-019)
李素霞,女,博士,副主任醫(yī)師。研究方向:血液病診斷及治療。Email: lisuxia301@163.com
朱宏麗,女,主任醫(yī)師,碩士生導(dǎo)師。Email: bjzhl202@ sina.com
解放軍醫(yī)學(xué)院學(xué)報(bào)2014年8期