目的：
許多SNP已被發現與乳癌有關，但SNP間的交互作用卻鮮少被提出。在這個研究中我們著重與癌症途徑相關的7個CXCL12基因之SNP點共同組合作用。
病人與方法：
在本研究中，SNP基因型是利用PCR- restriction fragment length polymorphism (RFLP)方法，所測得(病例：220；對照：334)不同數目的SNP基因型組合，稱為pseudo-haplotypes。以來自不同染色體的pseudo-haplotypes來評估乳癌危險性的共同作用。
結果：
除了VEGF rs3025039-CT外，沒有其他SNPs被發現對於乳癌風險有獨立貢獻。然而2個組合的SNPs中rs2228014-1801157
(CXCR4-CXCL12) pseudo-haplotype，帶有CC-GG基因型有乳癌的人數比例顯著低於沒有CC-GG基因型的人。同樣地，乳癌的發生，在3個或4個組合SNPs中rs12812942-rs2228014-rs3025039
(CD4-CXCR4-CXCL12)-rs12812942-rs3136685-rs2228014-rs1801157(CD4-CCR7-CXCR4-CXCL12) pseudo-haplotype基因型(AT-CC-CC 和 AT-AG-CC-GG)，也具有顯著低的危險性相關。更多大於5個SNP的組合也顯示相同效應。在控制年齡之後，比較他們共同回應的non-pseudo-haplotype和特定2到7個SNPs的pseudo-haplotyeps，乳
癌的OR值 (odds ratios)的範圍介於0.20~0.71。
結論：
我們已發現CXCL12相關的SNPs基因型組合能夠影響台灣乳癌婦女之危險度並趨近保護作用的形成。

Purpose：
Many single nucleotide polymorphisms (SNPs) have been found to be associated with breast cancer but their SNP interactions are seldom addressed. In this study, we focused on the joint effect for SNP combinations of seven CXCL12-related genes involved in major cancer related pathways.
Patients and Methods：
SNP genotyping was determined by PCR-restriction fragment length polymorphism (RFLP) in this study (case = 220, control = 334). Different numbers of combinational SNPs with genotypes called the pseudo-haplotypes from different chromosomes were used to evaluate their joint effect on breast cancer risk.
Results：
Except for VEGF rs3025039-CT, none of these SNPs was found to individually contribute to breast cancer risk. However, for two combined SNPs, the proportion of subjects with breast cancer was significantly low in the pseudo-haplotype with CC-GG genotypes in rs2228014-1801157 (CXCR4-CXCL12) compared to those with non-CC-GG genotypes. Similarly, the pseudo-haplotype of rs12812942-rs2228014-rs3025039 (CD4-CXCR4-CXCL12) And rs12812942-rs3136685-rs2228014
-rs1801157(CD4-CCR7-CXCR4-CXCL12)with specific genotype pattern (AT-CC-CC and AT-AG-CC-GG) among three and four combinational SNPs were significantly low in breast cancer occurrence. More SNP combinations larger than five SNPs were also addressed and shown the
similar effect.
After controlling for age, comparing to their corresponding non-pseudo-haplotypes, the estimated odds ratios for breast cancer ranged between 0.20 and 0.71 for specific pseudo-haplotypes with two to seven SNPs.
Conclusion：
We have identified the potential combined CXCL12-related SNPs with genotypes that were protective against breast cancer and may have an impact on identification of a low risk population for the development of breast cancer.

中文摘要 ………………………………………… 1
英文摘要 ……………………………………… 3
第一章 緒論
第一節、前言 ………………………………… 5
第二節、乳癌的形成及分期…………………… 9
第三節、乳癌的分類及治療 …………………11
第四節、文獻探討 …………………………14
第五節、研究動機 ……………………… 19
第二章 實驗方法及步驟
第一節、研究對象 ……………………… 20
第二節、研究材料與方法 ……………… 20
第三節、聚合鍊連鎖反應…………………22
第四節、鑑定SNP假對偶基因型……………… 23
第五節、統計方法…………………………… 23
第三章 結果
第一節、乳癌與CXCL12相關基因型之個別關聯性…………24
第二節、鑑別SNP假對偶基因………………24
第三節、探討CXCL12相關基因合併與乳癌的相關性25
第四章 討論 …………………………………26
第五章 圖表......................................29-45
第六章 參考文獻 …………………46-56
第七章 附錄.........................................60-87

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