Analysis Of The Clinical Features And The Expression Of OPRM1(A118G) Gene In Patients With Moderate And Severe Cancer Pain

Objectives:By collecting the clinical data of patients with moderate and severe cancer pain diagnosed by pathology and treated with opioid drugs,Analysising of the clinical characteristics of patients with moderate and severe cancer pain and its relationship with the dosage of opioid drugs,and discussing the influencing factors of opioid tolerance.To detect the polymorphism of OPRM1(A118G)gene in patients with moderate and severe cancer pain,and to analyze the effect of the gene polymorphism on the dosage of opioid drugs and the relationship with opioid adverse reactions.Methods:We collected the clinical data of patients with moderate and severe cancer pain diagnosed by pathology and treated with opioid drugs from December,2016 to January,2018.The clinical data of patients include:age,gender,disease type,stage,dosage of opioid,body mass index,bone metastasis,combined use of non steroidal anti-inflammatory drugs,Gaba Martin and other adjuvant drugs,combined with antitumor treatment.According to the standard of pain control,the patients with good pain control were analyzed that the relationship between the clinical characteristics of the patients and the dosage of opioid drugs,discussed the influence factors of opioid tolerance.After informed consent,the OPRM1(A118G)gene of patients with moderate and severe cancer pain was detected by the digital fluorescent molecular hybridization.Analyzing the influence of the gene polymorphism on the dosage of opioid drugs and the relationship of the gene polymorphism with opioid adverse.The results were analyzed by SPSS22.0 software.Results:1.This study collected 106 cases of cancer patients,60 cases of male(56.6%),46 cases were female(43.4%);the median age was 55 years,60 years of age or older patients accounted for 41.5%,age less than 60 year old patients accounted for 58.5%;stage IV accounted for 91.5%of patients with bone metastases accounted for 50.9%.All severe lung cancer pain in patients with digestive system cancer accounted for 28.3%,accounting for 27.4%,other kinds of malignant tumor accounted for 44.3%.All patients were selected treatment with strong opioid based,92.5%patients with oral treatment,adjuvant drug treatment of 30.2%,80.2%patients received anti-tumor therapy.2.According to the standard of pain control,age,gender and disease,bone metastasis,adjuvant drugs,anti-tumor therapy and BMI are not significantly associated with anti-tumor therapy and BMI were no significant correlation with opioid dose(P>0.05,there is no statistical difference meaning).3.The two classification Logistic regression analysis of the influence factors of opioid tolerance showed that the risk factors for opiate tolerance in patients with severe cancer pain over 60 years old were 0.208 times as much as 60 years old(P=0.021,OR:0.203,95%CI:0.052-0.789).Gender,disease,bone metastasis,adjuvant drugs,anti-tumor therapy and BMI were not correlated with opiate tolerance(P>0.05).4.OPRM1(A118G)gene polymorphism was detected in 14 patients with moderate or severe cancer pain.The frequency of GG genotype was 7.1%,the frequency of AG genotype was 42.9%,the frequency of AA genotype was 50%,and the frequency of G allele is 28.6%.The median dose of opioid drugs(25-75%)in each genotype was AA type 80(45-100)mg,AG/GG type 80(40-160)mg.There were 6 cases adverse reactions of opioids in patients with type AA,and 4 cases in type AG/GG.Conclusions:1.In the study,patients with moderate to severe cancer pain were mainly in stage IV,and half of the patients were accompanied by bone metastases.2.The gender,age,disease type,bone metastasis,adjuvant drugs,anti-tumor therapy and BMI were no correlation with the dosage of opioids in patients with moderate or severe cancer pain.3.In patients with moderate or severe cancer pain,age over 60 may be a protective factor for opioid tolerance.4.In this study,the OPRM1(A118G)gene polymorphism in moderate and severe cancer pain patients was detected.There was no significant difference in the dosage of opioids between type AA and AG/GG,and the incidence of adverse effects of AA was more than AG/GG.