乳癌臨床存活率分析及Interleukin -25基因多型性相關性之研究

A Study of Breast Cancer Survival Rate and the Association with Polymorphisms of Interleukin-25 Gene

洪雅芬(Ya-Fen Hung)

指導教授 ： 章順仁

共同指導教授 ： 侯明鋒(Ming-Feng Hou)

高雄醫學大學/醫學院/醫學研究所/碩士(2008年)

摘要

本研究探討女性乳癌病人發病年齡、腫瘤分期、病理組織特性、腫瘤標記、治療方式與乳癌病患存活率的差異，另外探討Interleukin-25(IL-25；IL-17E)基因多型性與臨床數據之相關性以及與乳癌病患存活率之間是否有顯著的影響。
研究對象自1985年至2006年，從高雄醫學大學附設中和醫院一般病房蒐集953位確定診斷為乳癌的患者。研究內容包括：(1)調閱病歷記錄相關臨床數據，並與衛生署1996到2006年死因死亡檔資料比對，了解女性國人在相關臨床數據之顯著性差異及存活率差異。(2)從0、I、II、III腫瘤分期中，隨機取120~130位病患，利用ABI Prism 7500同步定量聚合酶連鎖反應檢定IL-25基因型態，分析其存活差異。利用卡方檢定、Student t-test、Kaplan-Meier、Log-Rank Test、Cox regression統計方法進行資料的分析。
結果顯示，乳癌病患的平均年齡為47.78歲，乳癌相關死因的五年存活率為95.12%，平均存活月數為92.62個月。存活分析指出病理組織、腫瘤分期、腫瘤大小、淋巴節轉移、淋巴轉移率、CA 15-3、荷爾蒙相關基接受器及荷爾蒙治療等臨床數據達顯著差異(P＜0.05)。Cox regression分析後發現，與乳癌存活的獨立預後因子為淋巴節轉移顆數及荷爾蒙治療達統計上的顯著性差異(P＜0.05)。荷爾蒙治療對於乳癌有保護作用(危險比為0.18)，P＝0.022。IL-25基因多型性與乳癌的存活率之間未達顯著性差異，與其他臨床數據之間未達顯著性差異。

關鍵字

乳癌 ； 存活分析 ； IL-25

並列摘要

This research focuses on the correlation between survival rate and the onset of age, TNM stage, pathology organization characteristics, tumor mark and treatment modality of breast cancer patients. Moreover, we also discuss the relevance between Polymorphisms of Interleukin-25 (IL-25; IL-17E) Gene and clinical data, as well as the influence of survival rate of breast cancer patients.
The object of study contains 953 patients who were diagnosed as breast cancer from Chung-Ho Hospital of Kaohsiung Medical University since 1985 to 2006. The research methodology includes: (1) To realize the relation between clinical data and survival rate, we survey the medical records of the patients and make a comparison to the datasets of the death registration of the Department of Health (DOH) since 1996 to 2006. (2) We randomly selected 120~130 samples from patients of stage 0, I, II, III, using ABI Prism 7500 Real-time PCR to examine polymorphisms of Interleukin-25 Gene, to analyze the differences in survival rate. The analysis were achieved by using the Chi-squrare test, Student t-test, Kaplan-Meier, Log-Rank Test and the Cox regression.
The result shows that average age of the breast cancer patients is 47.78 years old. The five years related survival rate of breast cancer is 95.12%, and the average survival lifetime is 92.62 months. The survival analysis pointed out that pathology organization characteristics, TNM stage, tumor size, regional lymph nodes, lymph nodes metastasis percent, CA15-3, hormone related receptor and hormone therapy have significant differences (P<0.05). By using Cox regression, we found that two independent prognosis factors, regional lymph notes and hormone therapy, achieve significant differences (P<0.05). Hormone therapy has the protection effect to the breast cancer (Hazard Ratio is 0.18；P=0.022). Polymorphisms of Interleukin-25 Gene do not have significant difference to the survival rate, as well as other clinical data.

並列關鍵字

Breast cancer ； Survival analysis ； IL-25

參考文獻

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