XPD751基因多态性与晚期NSCLC对GP方案化疗的敏感性  

Polymorphisms in XPD751 gene and sensitivity to Gemcitabine/Cisplatin chemotherapy in advanced stage of non-small-cell lung cancer

作　　者：丁忠海[1] 许林[1] 高长明[2] 吴建中[2] 史美祺[3] 冯继锋[3] 

机构地区：[1]南京医科大学附属江苏省肿瘤医院胸外科,江苏南京210009 [2]南京医科大学附属江苏省肿瘤医院流行病研究室,江苏南京210009 [3]南京医科大学附属江苏省肿瘤医院内科,江苏南京210009

出　　处：《南京医科大学学报（自然科学版）》2008年第4期457-461,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省科技厅社会发展重点项目(No.BS2006005);江苏省卫生厅医学科研项目(No.Z200609)

摘　　要：目的:研究DNA修复基因XPD751基因多态性与晚期非小细胞肺癌(NSCLC)对吉西他滨/顺铂(GP)方案化疗敏感性的关系。方法:收集经病理学确诊的晚期NSCLC116例,所有病例化疗前抽静脉血,提取白细胞DNA,用多聚酶链反应—限制性片段长度多态性(PCR-RFLP)分析技术检测XPD751基因型,所有患者均为GP方案化疗。结果:①在肺癌患者中,XPD751Lys/Lys、Lys/Gln和Gln/Gln基因型分别为94例(81.0%)、20例(17.2%)和2例(1.8%)。经化疗后,44例患者有效,总有效率37.9%。②XPD751Lys/Lys、Lys/Gln和Gln/Gln基因型有效率分别为39.4%、25.0%、100.0%,三者相比差异无统计学意义(χ2=4.775,P=0.093)。与携带Lys/Gln基因型患者相比,Lys/Lys基因型者对GP方案化疗效果无显著增加,调整性别、年龄、临床分期和细胞学类型后的OR=1.09,95%CI:0.95～1.51。③携带Lys/Lys基因型患者的恶心呕吐反应和脱发程度均高于Lys/Gln和Gln/Gln基因型患者(χ2=4.032,P=0.045;χ2=4.344,P=0.037)。结论:XPD751基因多态性与晚期NSCLC对GP方案化疗的敏感性无显著相关,但可作为预测GP方案化疗毒副反应的指标。Objective：To investigate the relationship between polymorphisms of DNA repair gene XPD751 and sensitivity to Gemcitabine/ Cisplatin （GP） chemotherapy in advanced non-small-cell lung cancer （NSCLC）. Methods ： 116 patients with NSCLC were analyzed. All patients were treated with GP chemotherapy,and DNA of peripheral blood leukocytes was obtained before therapy. XPD751 genotypes were detected by PCR-RFLP method. Results： （1）Of all cases,the frequencies of XPD751 Lys/Lys,Lys/Gln and Gln/Gln genotype were 81.0%, 17.2% and 1.8% ,respectively. The overall response rate of chemotherapy in all patients was 37.9%. （2） The response rate of chemotherapy among patients with XPD751 Lys/Lys,Lys/Gln and Gln/Gln genotypes were 39.4% ,25.0%, 100.0% ,respectively, and no significant difference was found （Χ^2 = 4.775,P = 0.093）. Comparing to patients with Lys/Gln genotypes,GP chemotherapy showed no significant superior effect in patients with Lys/Lys genotypes,adjusted for gender,age,clinical stage and cytology type （OR=1.09,95%CI ：0.95-1.51 ）. （3）The incidence rate of vomiting/nausea and alopecie in Lys/Lys genotype was significantly higher than other genotypes （Χ^2 = 4.032,P= 0.045;Χ^2 = 4.344,P = 0.037）. Conclusion：The polymorphisms of the XPD751 might not be associated with the clinical response to GP chemotherapy in advanced NSCLC,but could be used as a marker of toxicity prognosis.

关 键 词：NSCLC XPD751 基因多态性 化学治疗 

分 类 号：R730.53[医药卫生—肿瘤] R734.2[医药卫生—临床医学]