蟹足腫的基因學與共病

Genetics and Comorbidities of Keloids

孫雷銘(Lei-Ming Sun)

指導教授 ： 李元綺

臺北醫學大學/醫學科技學院/醫學資訊研究所/博士(2015年)

https://doi.org/10.6831/TMU.2015.00041

摘要

中文摘要
蟹足腫是一種皮膚癒合過程中不正常的纖維化增生。雖然它不會致命，但是會使病人
的外觀和心裡收到嚴重打擊。關於蟹足腫的病因我們至今仍然不清楚，而教科書有關
蟹足腫的章節份量都不多，無法滿足我們想要深入此疾病的慾望。因此本論文寫作的
目的之一便是希望讀者能靠著這本書就能瞭解從1817 年至今2014 年所有有關蟹足腫
的重要知識。
論文的前半部系統性的回顧蟹足腫從早期的流行病學研究、細胞型態研究，到中期的
單一基因或單一蛋白質研究，到近代的全基因組關聯研究、基因多型性、變異、基因
晶片等等研究所勾繪出來的蟹足腫的樣貌。後半部則開始敘述實驗。我們從兩種不同
的面向去進行實驗，一個是最新的，別人尚未深入檢討的microRNAs（miRNAs）和蟹
足腫的關係；另一個則是老式的流行病學研究，試圖釐清某些基本問題諸如：亞洲人
蟹足腫的發生率及盛行率為和？男性與女性的比例真的是1:1 嗎？蟹足腫是否與某些
疾病共同發生？關於miRNAs 與蟹足腫的關係我們採用間接的方式來做實驗，然而當
我們與其它在2012 到2014 使用miRNA array 的實驗結果比較時，赫然發現彼此間少
有交集。雖然沒有很漂亮的結果，但是我們從中瞭解到蟹足腫可能與miRNAs 無關或
者是由於miRNAs 的表現量與宿主基因沒有很強的正比關係，導致我們無法從基因晶
片的資料獲得正確的結果。而流行病學的研究則是使用2005 年健保承保抽樣歸人檔
來進行，我們發現女性在20~60 歲之間的盛行率明顯高於男性。另一個重要發現則是
蟹足腫與子宮肌瘤有統計上明顯相關性。這些研究的結果將引導我們進行下一階段實
驗。

關鍵字

蟹足腫 ； 基因學 ； 共病 ； 健保資料庫

並列摘要

Abstract
Keloids are an abnormal fibroproliferative disease during the healing process. Though
not lethal, it is unsightly and has a huge psychological impact on patients. The
pathoetiology of keloids is still unclear. There are few books or chapters focused on this
disease. It is, therefore, the first goal of this dissertation to remind readers of the
contemporary knowledges of keloids.
The anterior part of this dissertation is a review of previous researches, from the early
age of epideminological studies, anatomical or morphologic studies to the recent
gene/protein studies, whole genome linkage/ association study, gene polymorphism/
mutation, and microarray studies. The posterior part of this dissertation includes two
experiments. One is the most advanced microRNA study and the other is the
fundamental epidemiological study. In the microRNA study, we used an indirect method
to compare the expression levels of microRNAs between normal skin tissues and keloids.
Meanwhile, we compared our result with 4 studies that used direct microRNA arrays
from 2012 to 2014. The epidemiological study was based on the National Health
Insurance Research Database, which contains the data of 1 million randomly selected
patients. The result showed that the keloid incidence rate in Taiwan was around 0.15%,
which is similar to that in Caucasians, but is lower than that in Africans. Our study also
revealed that female patients exceeded male patients in the 20~60 years age group.
Another important finding of our study is about the comorbidities of keloids.
Multivariate logistic regression analysis was employed to estimate the relative odds of
keloids as a function of fibrotic diseases. We concluded that women with uterine
leiomyoma have a greater risk of keloids. These findings will lead us to find the etiology
of keloids.

並列關鍵字

keloid ； genetics ； miRNA ； NHIRD

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