Prevalence And Descendiblity Susceptility Analysis Of Reflux Esophagitis

1 Research background and purposeEsophageal carcinoma (esophageal carcinoma, EC) is one of the six big malignant tumors of the worldwide, China has the highest incidence and mortality in the world.Almost all the esophageal carcinomas of China are esophageal squamous cell carcinoma, but the esophageal carcinomas of west countries are mainly esophageal adenocarcinoma carcinoma,which reveals that the has obvious difference between the two morbidity patterns In west, the reflux esophagitis�'Barrett's esophagus�'esophagus adenocarcinoma was considered the model morbidity pattern of esophageal adenocarcinoma, therefore the reflux esophagitis was also considered one kind of precancerous of esophageal adenocarcinoma. In recent years, the incidence rate of reflux esophagitis also has the markup tendency in China,so the reflux esophagitis also bring more and more to people's attention. But the report about reflux esophagitis is really few, particularly report about its molecular machine-made is few really few. The purpose of this research is from the reflux esophagus's epidemiology characteristic analysis, take further to its molecular mechanism, to build a certain foundation for reflux esophagitis research of the west and east. This research using(Genome wide association study,GWAS).for some the designates case group and the control group to the designation some case group and the control group, to compared with all single nucleotide polymorphism (Single nucleotide polymorphism. SNP) position spot allele or genotype frequency of the entire genome team scope in difference between case group and control group's. The GWAS technology has become very mature form first developed to now, our topic-based group had once reported PLCE1 and the c20orf54 gene polymorphism using GWAS for esophageal carcinoma.This research through the analysis to case group and in control group's entire genome team all single nucleotide polymorphism (Single nucleotide polymorphism, SNP) position spot genotype and allele distributed, discovered that ADAMTS5 genome team rs2830856 was closely related to the highly susceptility of Chinese reflux esophagitis2. Material and method2.1. Objects of the studyFrom the First Affiliated Hospital of ZhengZhou Univerty, Henan Province People's Hospital, People's Hospital of PuYang,People's Hospital of XinYang, People's Hospital of ShangQi,AnYang Tumour hospital, the Attiliated Heping Hospital of Changzhi, the Affiliated TongRen Hospital of Capital Medical University.the Inner Mongolian medical college,and so on,there are altogether 15 hospital. From outpatient service we had inspected altogether 33375 examples with gastroscopy altogether 33375 examples from April 2009 to October,2010, the diagnosis is the RE altogether 915 examples. Meanwhile a topic-based group issue selects 271 examples scase group and 432 example scontrol groups to us in carries on the entire genome team to be connected using GWAS. And case group 271 examples (male/female,204/67, average age45±3); Control group 432 examples (male/female, 230/202, average age42±5) all object of study passes through the gastroscopy.2.2 Data originateADAMTS5 the gene polymorphism rs2830856 position spot gene to be divided (CC, CT, TT) the material to originate in this topic-based group esophagus cancer entire genome team is connected the analysis the Illumina 610 chips and a Sequenom chip gene minute data.2.3 Statistics processesThis research using the SPSS 17.0 software to carry on statistics analysis of the material, the statistical method uses the card side examination, the statistical result significance examination standard a=0.05, the relative risk factor with the superiority (Odds Ratio, OR) as well as 95% reliable intervals (95% Confidence Interval,95%CI) appraises. First, the case group and the control group according to the age, the sex, the family history carries on the lamination. We separately carried on frequency comparative analysis during each group and group's genotype and the allele.3 Results3.1 Analysis result of reflux esophagitis's popular characteristic3.1.1 Detection rate of RE between different sexsFrom the outpatient service of gastroscopy altogether 32003, picked out the 915 example RE, the detection rate of RE is 2.68% (915/32003 example), for female 1.47% (249/16723 example), male 3.94% (646/16403 example); the detection rates of male and female had remarkable statistics difference (P<0.05)3.1.2 Detection rate of RE between different age groupsDivides into the youth group according to the age (<40 year old) is 2.33% (190/17235), the middle-aged group (40-59 years old) are 3.03% (439/14490), the old age group (>59 year old) is 4.65% (262/5639); The differences of detection rate among the three groups had remarkable statistics meaning (P＜0.05), the difference of each two groups of detection rate had remarkable statistics meaning(P<0.01).3.1.3 Detection rate of RE in high/low esophageal carcinoma areasIt is 1.53% (182/11913 example) in high area,3.37% in low area (694/20621 example); the differences between the two areas are remarkable (P<0.05),3.1.4 Detection rate of RE of different BMI groupsIt is 1.49%(19/1271 example)in low group,1.68% (126/7509 example) in normal group,2.8% (130/4646 example) in overweight and obese group; difference among the groups are obvious (P<0.05); Difference of detection rate between overweight and normal group is obvious (P<0.017), difference of detection rate between obese and thin group is not remarkable (P>0.017), difference of detection rate between obese and thin group is remarkable (P<0.017)3.1.5 Detection rate of RE of different blood-groupsIt is 2.45%(105/4287) of A,2.14%(108/5057) of B,2.82% (47/1666) of AB, 2.31%(111/4801) of O; differences among four groups do not have statistics significance (P>0.05), the differences of detection rate between random two bloods-group has not counted the remarkable statistics significance (P>0.05).3.2 Results of result of reflux esophagitis3.2.1 Gene AADAMTS5, rs2830856 genotype distribution difference between case group and control group's population has statistics significance (X2=9.423, df=2, P=0.009), the difference of allele distribution frequency between case group and control group also has statistics significance (x2=7.73, df=1, P=0.005, OR=1.37,95% CI:1.097-1.714).3.2.2 The frequency RE of the group TT/CT genotype and the T allele's is obviously higher than the control group, TT and the CT genotype and the T allele possibly are the dangerous factors of RE.3.2.3 Carries on the lamination analysis according to the sex, the result demonstrating: in male and feminine crowds, distribution frequency difference at this spot genotype between the RE group and the control group havn't statistics significance (x2=4.218, P=0.121; X2=3.111, P=0.211). The distribution difference of allele at the spot also have no statistics significance (x2=3.26,P=0.071, OR=1.29,95%CI(0.978-1.702); X2=0.758,P=0.384,OR=0.837,95%CI:0.561-1.249).3.2.4 Carries on the lamination analysis according to the age.The result demonstrating:the frequency different of the spot genotype has statistics significance for<40 years old between the RE group and contral groups, the frequency different of the spot genotype have't statistics significance for 40-59 and>59 years old between the RE group and contral groups, (x2=10.831, P=0.004; x2=3.556, P=0.169; X2=1.232, P=0.54). This spot allele distribution difference have no statistic significance(x2=0.358,P=0.55,OR=0.857,95%CI(0.517-1.421);x2=2.459,P=0.117,OR =1.281,95%CI:0.94-1.745); x2=0.437, P=0.508, OR=1.149,95%:0.761-1.736). Which prompts the difference only exists in the low age group.3.2.5 For family history masculine patients, the distribution difference of rs2830856 position spot of genotype hasn't statistics significance, and the distribution difference of allele has non-statistics significance (x2=5.65, df=2, P=0.059; x2＝0.758, df=1, P=0.015, OR 2.212,95%CI (1.157-4.229)). For family history negative patients, the distribution difference in rs2830856 position spot the genotype has statistics significance, the distribution difference of allele has non-statistics significance (X24.967, df=2, P=0.083;X2=4.18, df=1, P=0.041, OR=1.287,95% CI (1.01-1.64)).3.2.6 Distribution difference of rs 2830856 position spot of genotype between men and women patients hasn't statistics significance, distribution difference of allele has statistics significance (x2=4.16, df=2, P=0.125; x2=3.98, df=1, P=0.046, OR=1.496, 95%CI:1.006-2.225).3.2.7 The distribution differences in rs2830856 position spot of genotype and the allele did not have statistics significance for<40/40-59/>59years old (x2=4.341, df=2, P=0.362;x2=3.557,P=0.169). Compared with each morbidity age section,ADAMTS5 gene of rs2830856 position spot genotype frequency have non-significance difference(x2=3.557, P=0.169).3.2.8 Between the family history masculine patient and the negative patient, the distribution difference of rs2830856 position spot genotype and the allele does not have statistics significance(X2= 2.16, df=2, P=0.339; x2=2.050, df=1, P=0.152, OR=1.547,95% CI (0.848-2.823).4. Conclusions4.1 The male are subject to reflux esophagitis4.2 The old people are subject to reflux esophagitis4.3 The obesity are subject to reflux esophagitis4.4 The occurrence of reflux esophagitis has nothing to do with blood-groups. 4.5 The gene ADAMTS5 rs2830856 heredity polymorphism relates Chinese crowd heredity susceptivity.TT and the CT genotype and the T allele are possibly the heredity dangerous factors of RE.4.6 The has no differences of the gene ADAMTS5 rs2830856 heredity polymorphism between sex, the age, the family history4.7 The has relativity of rs2830856 polymorphism with the small age,but no relativity with sex, the family history masculine of RE.