OPRM1(A118G)基因多态性与肺癌癌痛患者镇痛效果的相关性

目的:探讨阿片样物质受体(μ1 opioid receptor,OPRM1)(A118G)基因多态性与肺癌癌痛患者镇痛效果的相关性。方法:选取本院2017年3月至2019年10月收治的360例肺癌患者作为研究对象,判断患者阿片耐受与不良反应发生情况。收集患者血液指标,检测OPRM1(A118G)基因多态性情况并进行相关性分析。结果:在360例患者中,阿片耐受78例(耐受组),耐受率为21.7%;耐受组的性别、年龄、体重指数、肿瘤最大直径等与非耐受组对比差异无统计学意义(P0.05),两组临床分期与淋巴结转移等对比差异有统计学意义(P0.05)。OPRM1(A118G)基因共有AA、AG、GG三种基因型,两组人群的OPRM1(A118G)基因型分布均符合Hardy-Weinberg平衡定律;两组OPRM1(A118G)基因型分布差异具有统计学意义,耐受组的OPRM1(A118G)基因GG基因型比例显著高于非耐受组(P0.05),等位基因G频率显著高于非耐受组(P0.05);耐受组的呼吸抑制、恶心呕吐、头晕、皮肤瘙痒等不良反应发生率为35.9%,显著高于非耐受组的2.8%(P0.05)。直线相关性分析显示OPRM1(A118G)基因GG基因型与阿片耐受、淋巴结转移、临床分期都呈现相关性(P0.05);二分类变量Logistic回归分析显示OPRM1(A118G)基因GG基因型、临床分期、淋巴结转移为影响阿片耐受的主要因素(P0.05)。结论:肺癌癌痛患者在镇痛中存在阿片耐受情况,与患者的OPRM1(A118G)基因多态性与治疗不良反应显著相关,OPRM1(A118G)基因GG基因型、临床分期、淋巴结转移为影响阿片耐受的主要因素。

Correlation between OPRM1 (A118G) Gene Polymorphism and Analgesic Effect in Patients with Lung Cancer Cancer Pain

ABSTRACT Objective: To investigate the correlation between the opioid receptor (OPRM1) (A118G) gene polymorphism and the analgesic effect of patients with lung cancer and cancer pain. Methods: From March 2017 to October 2019, A total of 360 cases of patients with lung cancer treated in our hospital were selected as the research subjects, and were to determine the incidence of opioid tolerance and adverse reactions. The blood indexes of patients were collected, and the polymorphism of OPRM1 (A118G) gene were detected and the correlation analysis were performed. Results: In the 360 cases, there were 78 cases were tolerated by opioids (tolerated group), with the tolerance rates were 21.7 %, the gender, age, body mass index, and tumor diameter of the tolerated group were not different compared to the non-tolerated group(P>0.05), and the clinical stage and lymph node metastasis were significantly different compared between the two groups (P<0.05). The OPRM1 (A118G) gene were three genotypes of AA, AG, and GG. The OPRM1 (A118G) genotype distribution of the two groups of populations conforms to Hardy-Weinberg equilibrium law, the compared difference in the OPRM1 (A118G) genotype distribution of the two groups were statistically significant. The ratio of GG genotype of OPRM1 (A118G) gene in thetolerated group were significantly higher than that in the non-tolerated group (P<0.05), and the allele G frequency were significantly higher than that in the non-tolerated group (P<0.05). The incidence of adverse reactions such as nausea, vomiting, dizziness, and itching of the skin in the tolerated group were 35.9 %, which were significantly higher than the non-tolerated group of 2.8 % (P<0.05). Linear correlation analysis showed that the GG genotype of OPRM1 (A118G) gene were correlated with opioid tolerance, lymph node metastasis, and clinical stage (P<0.05). Logistic regression analysis of the binary classification variable showed that GG OPRM1 (A118G) gene genotype, clinical staging and lymph node metastasis were the main factors affected opioid tolerance (P<0.05). Conclusion: Patients with lung cancer and cancer pain have opioid tolerance during analgesia, which are significantly related to the patient''s OPRM1 (A118G) gene polymorphism and adverse treatment response. The OPRM1 (A118G) gene GG genotype, clinical stage, and lymph node metastasis are the the main factor for opioid tolerance.