5-羟色胺2A受体基因多态性与肺癌患者疼痛发生及阿片类药物需求量的相关性研究

目的:探讨5-羟色胺2A受体(5-HT2AR)基因rs6313位点多态性与肺癌患者疼痛发生及阿片类药物需求量的相关性。方法:选取2017年12月-2018年6月徐州医科大学附属医院收治的肺癌患者332例,作为肺癌组;根据其是否发生疼痛分为疼痛组(177例)和无痛组(155例)。选取同期于该院行体检的健康者116例,作为对照组。采用聚合酶链反应-限制性片段长度多态性方法检测各受试者5-HT2AR基因rs6313位点的基因型。采用χ^2检验比较各组患者基因型分布情况,采用二元Logistic回归分析法、χ^2检验、Kruskal-Wallis检验分别考察基因型与肺癌患者疼痛发生、疼痛程度以及阿片类药物需求量的相关性。结果:共检出5-HT2AR基因rs6313位点CC、CT、TT等3种基因型。对照组、无痛组、疼痛组受试者上述基因型频率分别为20.7%、47.4%、31.9%,20.6%、50.3%、29.0%以及16.4%、50.8%、32.8%,其频率及等位基因频率均符合Hardy-Weinberg平衡(P>0.05)。肺癌组患者各基因型及等位基因频率与对照组比较,差异均无统计学意义(P>0.05)。TNM分期(Ⅲ~Ⅳ期)与肺癌患者疼痛发生有关[比值比为3.661,95%置信区间(1.972,6.797),P<0.001],而性别、年龄、身高、体质量、病理分型和rs6313位点基因型与患者疼痛发生无关(P>0.05),且该位点基因型与肺癌患者疼痛程度以及阿片类药物需求量均无关(P>0.05)。结论:5-HT2AR基因rs6313多态性与肺癌患者疼痛的发生及阿片类药物的需求量无关,其多态性可能不是导致肺癌患者疼痛个体差异的主要原因。

Study on Correlation of 5-hydroxytryptamine 2A Receptor Gene Polymorphism with Pain Occurrence and Opioid Requirements in Patients with Lung Cancer

OBJECTIVE: To investigate the correlation of 5-hydroxytryptamine 2A receptor (5-HT2AR) rs6313 gene polymorphism with pain occurrence and opioid requirements in patients with lung cancer. METHODS:Totally 332 patients with lung cancer were selected from the Affiliated Hospital of Xuzhou Medical University during Dec. 2017-Jun. 2018 as lung cancer group. They were divided into pain group(177 cases)and painless group(155 cases)according to whether pain occurred. Totally 116 healthy persons who underwent physical examination in same period were selected as control group. The genotype of rs6313 locus of 5-HT2AR gene was detected by PCR-RFLP. The distribution of genotype was compared by χ^2-test. The correlation of genotype with pain occurrence and degree,opioids requirements were investigated by Binary Logistic regression analysis,χ^2-test and Kruskal-Wallis test. RESULTS:CC,CT,TT genotypes were detected in rs6313 locus of 5-HT2AR gene. The frequency of above genotypes were 20.7%,47.4%,31.9%,20.6%,50.3%,29.0% as well as 16.4%,50.8%,32.8%,respectively in control group,painless group and pain group. Their frequencies and allele frequencies were in line with Hardy-Weinberg balance(P> 0.05). There was no statistical significance in genotype and allele frequencies between lung cancer group and control group(P> 0.05). TNM staging(Ⅲ-Ⅳ stage)was associated with pain in lung cancer patients [OR=3.661,95%CI(1.972,6.797),P< 0.001]. Gender,age,height,body weight,pathological typing and rs6313 locus genotype had no correlation with pain(P>0.05). The genotype of this locus was not related to the degree of pain and the requirements for opioids in patients with lung cancer(P>0.05). CONCLUSIONS: The polymorphism of 5-HT2AR gene rs6313 locus is no related to pain occurrence and opioid requirements in patients with lung cancer. Its polymorphism may not be the main cause of individual pain differences in lung cancer patients.