| Objective To confirm the interaction of environment,JWA gene polymorphism,micro RNA polymorphism in inflammatory pathway,NEIL2 gene polymorphism and esophageal squamous carcinoma by epidemiological investigation.In the tumor micro-environment, inflammatory cells play an important role,especially on the prognosis in cancer patients.In this study,we explore the relationship of NLR and prognosis as well as NLR and micro RNA polymorphism in inflammatory pathway in order to improve the prevention and the treatment of esophageal squamous carcinoma in Zhangzhou,Fujian. Methods 1. A 1:1 matched case-control study was conducted by the unified form.A total of 559 esophageal squamous carcinoma patients by pathological diagnosis and 559 control subjects were recruited from The Zhangzhou Hospital.The interaction were evaluated with the Mutifactor dimensionality reducation(MDR) model. 2.Collected the clinical data and preoperative neutrophil-to-lymphocyte ratio(NLR) of the patients after radical esophagectomy between January 2010 and December 2014,then did follow-up. To evaluate the best cut-off points of NLR with the X-title sofeware.Base the best cut-off points of NLR,we analyzed NLR and prognosis as well as NLR and micro RNA polymorphism in inflammatory pathway. Results 1.Result univariate analysis showed that drinking tea year was a risk factor of ESCC OR=1.445(95%CI:1.186~1.759),then stratification analysis showed that no correlation between drinking tea year and ESCC among those who had not drank hot tea,but the higher correlation among those who had drank hot tea OR=1.788(95%CI:1.151~2.748). 2.The environment-environmental interaction study presented that the interactions between hot-eating habit and consumed fresh fruits was an antagonism effect,which had anmultiplicative interaction term with P=0.968 and RERI of 0.839( 95%CI=-0.879 ~2.566),AP of 0.220(95%CI=-0.184~0.623)and S of 1.424(95%CI=0.668~3.306).Those who had hot-eating habit and consumed fresh fruits <1 times per week had more risk of esophageal squamous carcinoma compared with those who had not hot-eating habit and consumed fresh fruits ≥3 times per week(OR=4.905,95%CI:2.488~9.670). 3.The gene-gene interaction study presented that JWA gene rs7038 and NEIL2 gene rs8191613 may have a synergy effect.Persons who carry with rs7038 polymorphic loci(TG+GG)and rs8191613 wild type had more risk of ESCC(OR=1.860,95%CI:1.083~3.195).But rs7038 polymorphic loci(TG+GG)and rs8191613 polymorphic loci(GA+AA) had not an effect on ESCC. 4.The gene-environmental interaction study presented that the best interactions model was the interaction among smoke and rs7038 and rs8191613.The interaction effect had an association with esophageal squamous carcinoma(OR=2.516,95%CI:1.082~5.848).The multiplicative was not observed between smoke and rs7038,but there were the multipicative interaction between smoke and rs8191613(OR=1.898,95%CI:1.010~3.576). 5.The best cut-off points of NLR was 1.64.Univariate analysis revealed that higher NLR was an significant prognostic risk factor of survival(HR=1.932,95%CI:1.161~3.212). 6. NLR and Tumor differentiation had an effect on prognosis. Patients who had higher NLR with middle degree of differentiation had more risk of survival HR=1.962(95%CI:1.071~3.593),so did patients who had higher NLR with low degree of differentiation(HR= 1.177,95%CI:1.177~22.906).But there was not an significant correlation between NLR and prognosis in patients of well differentiated ESCC. 7.The inflammatory marker scoring which combined NLR and serum albumin was an an significant prognostic risk factor of survival.The inflammatory marker scoring 2 point predicted poor prognosis(HR=4.351,95%CI:1.579~11.993)and scoring 1 point also had a poor prognosis(HR=2.008,95%CI:1.192~3.385). 8.Correlation are not statistically significant between NLR and micro RNA polymorphisms in inflammatory pathway,so was results in stratification analysis.Conclusions 1.Drinking tea years has the greater risks of ESCC,which may be due to like to drink hot tea in Zhangzhou,Fujian. 2.To avoid developing a hot-eating habit and eat more fresh fruits can help prevent ESCC.The gene-gene interaction of rs7038 and rs8191613 may plays a supplementary role in the process of esophageal squamous carcinoma caused by the adverse environmental factors. 3.Preoperative NLR which the best cut-off point is 1.64 can be a clinically inflammatory marker for assessment of prognosis of ESCC patients in Zhangzhou,Fujian. 4.Preoperative NLR and tumor differentiation had an effect on prognosis with no significant correlation between NLR and prognosis in patients of well differentiated ESCC. 5.The inflammatory marker scoring was an new scoring standards of inflammatory,a higher scoring which predict a poor prognosis and could be helpful for clinical practice. |
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