ERCC1和TUBB3联合检测对晚期胃癌个体化治疗的应用分析  

Individualized chemotherapeutic regimen guided by combined detection of ERCC1 and TUBB3 genes in patients with advanced gastric cancer

作　　者：杨洋[1] 李良庆[1] 陈群[1] 陈辉[1] 潘敦[1] 张琳[1] 

机构地区：[1]福建医科大学附属第一医院胃肠外科一区,福建福州350005

出　　处：《中国现代普通外科进展》2014年第1期20-23,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨多基因mRNA联合检测对晚期胃癌个体化化疗疗效和预后的影响。方法:将98例晚期胃癌化疗患者随机分为2组,对照组采用DCF(多西紫杉醇+顺铂+5-FU)方案,研究组进行ERCC1、TUBB3基因mRNA表达水平检测,并根据检测结果针对性地选择DCF方案、FOLFOX4(奥沙利铂+5-FU)方案、FOLFIRI(伊立替康+5-FU)方案、TF(紫杉醇+5-FU)方案。观察2组患者的不良反应、生活质量、化疗有效率(RR)和中位疾病进展时间(mTTP)、中位生存时间(mOS)。结果:研究组的RR高于对照组,但差异无统计学意义(P>0.05);研究组与对照组mTTP分别为9.5个月和6.4个月,mOS分别为13.7个月和10.2个月,差异均有统计学意义(P<0.05);对照组不良反应包括骨髓抑制、肝肾损害,其发生率均明显高于研究组(P<0.05);2组生活质量改善率的差异也有统计学意义(P<0.05)。结论:ERCC1、TUBB3联合检测及基于其基础上的化疗对晚期胃癌患者具有针对性强、安全性高、副作用小的优点,能提高患者生活质量,并可延长生存期。Objective： To analyze the impact of gene mRNA expression in tumors on chemoresponse and clinical outcome of patients with advanced gastric cancer treated with chemotherapy. Methods： A total of 98 gastric cancer patients were randomly divided into two groups. The control group received DCF. The ERCC1 ,TUBB3 mRNA expressions of the patients of experiment group were detected at first. Then the above chemotherapy regimen was administered according to the detection results. Treatment efficiency, toxicity, quality of life, median time to progression （mTTP）, and median overall survival （mOS） time were observed and analyzed, Results： The difference about the rates of chemotherapeutic efficiency in the TG and CG was not statistically significant. The mTTP did statistically differ between the groups （TG, 9.5 months; GC, 6.4 months）. The mOS rates in the TG and CG were 13.7 and 10.2 months, and the difference was significant. The toxicity reactions and the improvement rate of quality of life were significantly, with the difference being statistically significant. Co^l~ The target detection and individualized regimen for advanced gastric cancer treatment has the advantages of more individualisation, lower side effects, higher safety, and lower localized recurrence than conventional chemotherapy. And it is also getting improved quality life and longing survival time.

关 键 词：晚期胃癌 基因检测 ERCC1 TUBB3 个体化治疗 

分 类 号：R735.2[医药卫生—肿瘤]