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基于顺铂化疗的成年癌症幸存者言语识别阈后综合关联分析。

Comprehensive association analysis of speech recognition thresholds after cisplatin-based chemotherapy in survivors of adult-onset cancer.

机构信息

Department of Medicine, University of Chicago, Chicago, Illinois, USA.

Department of Medical Oncology, Indiana University, Indianapolis, Indiana, USA.

出版信息

Cancer Med. 2023 Feb;12(3):2999-3012. doi: 10.1002/cam4.5218. Epub 2022 Sep 12.

Abstract

PURPOSE

Deficits in speech understanding constitute one of the most severe consequences of hearing loss. Here we investigate the clinical and genetic risk factors for symmetric deterioration of speech recognition thresholds (SRT) among cancer survivors treated with cisplatin.

METHODS

SRT was measured using spondaic words and calculating the mean of measurements for both ears with symmetric SRT values. For clinical associations, SRT-based hearing disability (SHD) was defined as SRT≥15 dB hearing loss and clinical variables were derived from the study dataset. Genotyped blood samples were used for GWAS with rank-based inverse normal transformed SRT values as the response variable. Age was used as a covariate in association analyses.

RESULTS

SHD was inversely associated with self-reported health (p = 0.004). Current smoking (p = 0.002), years of smoking (p = 0.02), BMI (p < 0.001), and peripheral motor neuropathy (p = 0.003) were positively associated with SHD, while physical activity was inversely associated with SHD (p = 0.005). In contrast, cumulative cisplatin dose, peripheral sensory neuropathy, hypertension, and hypercholesterolemia were not associated with SHD. Although no genetic variants had an association p value < 5 × 10 , 22 genetic variants were suggestively associated (p < 10 ) with SRT deterioration. Three of the top variants in 10 respective linkage disequilibrium regions were either positioned within the coding sequence or were eQTLs for genes involved in neuronal development (ATE1, ENAH, and ZFHX3).

CONCLUSION

Current results improve our understanding of risk factors for SRT deterioration in cancer survivors. Higher BMI, lower physical activity, and smoking are associated with SHD. Larger samples would allow for expansion of the current findings on the genetic architecture of SRT.

摘要

目的

言语理解能力的缺陷是听力损失最严重的后果之一。在这里,我们研究了接受顺铂治疗的癌症幸存者中言语识别阈值(SRT)对称恶化的临床和遗传风险因素。

方法

使用斯邦达词测量 SRT,并计算双耳对称 SRT 值的平均值。对于临床关联,SRT 相关听力障碍(SHD)定义为 SRT≥15dB 听力损失,临床变量来自研究数据集。使用基于等级的逆正态转换 SRT 值作为响应变量的 GWAS 对基因分型的血液样本进行基因分型。在关联分析中,年龄用作协变量。

结果

SHD 与自我报告的健康状况呈负相关(p=0.004)。当前吸烟(p=0.002)、吸烟年限(p=0.02)、BMI(p<0.001)和周围运动神经病(p=0.003)与 SHD 呈正相关,而体力活动与 SHD 呈负相关(p=0.005)。相比之下,累积顺铂剂量、周围感觉神经病、高血压和高胆固醇血症与 SHD 无关。尽管没有遗传变异与 SHD 有显著关联(p<5×10),但 22 个遗传变异与 SRT 恶化呈显著相关(p<10)。在 10 个相应连锁不平衡区域的前三个变体中,有三个要么位于编码序列内,要么是参与神经元发育的基因的 eQTL(ATE1、ENAH 和 ZFHX3)。

结论

目前的结果提高了我们对癌症幸存者 SRT 恶化风险因素的理解。更高的 BMI、更低的体力活动和吸烟与 SHD 相关。更大的样本量将允许扩展当前关于 SRT 遗传结构的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/672a/9939144/a370fd4ca961/CAM4-12-2999-g006.jpg

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