Epidemical Survey Of PLGC Of Phlegm-accumulation Stasis And Association With The Polymorphism Of TLR4 Gene

Objective: To investigate the association between various risk factors and precancerous lesion of gastric cancer(PLGC) in patients from Jiangsu. This study aimed to assess Toll-like receptor 4(TLR4)(rs4986790, rs4986791, rs10759932) polymorphisms at risk of precancerous lesion of gastric cancer(PLGC) of Phlegm-Accumulation Stasis in a Chinese Han population.Methods: 501 cases of PLGC of Phlegm-Accumulation Stasis and 523 cases of superficial gastritis were included. A comparative study of the relation between different risk factors and PGLC of Phlegm-Accumulation Stasis was performed. In this hospital-based case-control study, gene polymorphisms were analyzed in 333 patients(Intestinal metaplasia:n=193; Intraepithelial neoplasia: n=140) and 312 atopy-free controls of Chinese Han population population. TLR4(rs4986790, rs4986791, rs10759932) were performed using Taqman allelic discrimination assays.Result: 1. Statistical differences were noted in a series of indexes including Helicobacter pylori(HP) infection, family history of esophageal cancer(EC), gastric cancer(GC) and chronic atrophic gastritis(CAG), personal history of CAG, gastric polyps(GP)and gastric ulcer(GU), usage of non-steroids(e.g. aspirin), gastroesophageal reflux disease(GERD), drinking alcohol, eating food rich in nitroso compounds, irregular eating habits with no breakfast, ingestion of smoked meat, fried food and spicy food, anxiety and depression.2. The risk factors associated with PLGC ranked in an order of personal history of CAG, GP, family history of GC, usage of non-steroids(e.g. aspirin), ingestion of spicy food frequently, personal infection with HP, family history of EC, drinking alcohol, anxiety, personal history of GU, GERD and family history of CAG.(3) The single nucleotide polymorphisms TLR4 rs4986790, rs4986791 was not associated with risk of chronic gastritis or gastric cancer and the homozygous genotypes TLR4 rs4986790 GG and TLR4 rs4986791 TT were absent in the studied population. In the single-locus analysis, the C allele of rs10759932 had a significantly reduced risk of IM and IN(adjusted odds ratio(OR) = 0.42; 95%CI = 0.29-0.62 and OR=0.62; 95%CI = 0.41-0.93, respectively), compared with the wild-type homozygote(TT). The frequency of the TLR4 rs10759932 TC tended to be lower in patients with IM and IN than in controls(OR= 0.37; 95%CI = 0.24-0.55 and OR=0.60; 95%CI = 0.39-0.93, respectively). The frequencies of TLR4 rs10759932 TC and T carrier were significantly lower in patients with Sydney’s slight IM and LGIN(P < 0.01 and P = 0.01, respectively), meanwhile the TC genotype showed a lower risk of moderate IM compared to healthy individuals(P=0.045). There were no significantdifferences between these groups in the distribution of age, sex and smoking status. But Helicobacter pylori infection, drinking, salt uptake were associated with a higher susceptibility to developing this neoplasm.Conclusion: 1. Personal history of CAG was most associated with PLGC in patients from eastern China, followed by personal history of GP and family history of GC. 2. Our data suggests that TLR4 rs10759932 TC and C carrier were associated with a lower risk of developing PLGC of Phlegm-Accumulation Stasis, and these genotypes may reduce the risk of IM and IN in a Chinese Han population.