机构地区:[1]安徽医科大学第一附属医院肿瘤内科,合肥230022
出 处:《临床肿瘤学杂志》2015年第5期427-432,共6页Chinese Clinical Oncology
摘 要:目的探讨晚期消化道恶性肿瘤患者外周血淋巴细胞(PBLC)的DNA修复率(DRR)与含铂联合化疗方案疗效的关系。方法通过单细胞凝胶电泳法检测112例晚期消化道恶性肿瘤患者(肿瘤组)PBLC的DRR,另选取60例健康体检者作为对照(对照组)。肿瘤组患者均接受含铂联合化疗方案治疗并评价近期疗效,分析两组铂类暴露前与暴露修复后的DRR及肿瘤组DRR与临床病理特征及含铂联合化疗方案疗效的相关性。结果利用尾长(TL)和尾相(TM)检测食管癌(Z=-4.687,P=0.000;Z=-4.939,P=0.000)、胃癌(Z=-5.473,P=0.000;Z=-3.789,P=0.000)及结直肠癌(Z=-5.796,P=0.000;Z=-5.206,P=0.000)的PBLC DRR均低于对照组。肿瘤组的PBLC DRR与性别、年龄、ECOG评分、嗜酒习惯和组织分化均无关(P>0.05)。112例患者中110例可评价疗效,其中食管癌PR 3例、SD 6例、PD 12例,有效率(RR)为14.3%,疾病控制率(DCR)为42.9%;胃癌CR 1例,PR 5例、SD 10例、PD 20例,RR为16.7%,DCR为44.4%;结直肠癌CR 2例、PR 8例、SD 13例、PD 30例,RR为18.9%,DCR为43.4%。以TL作为评价DRR的指标,提示食管癌(r=-0.500,P=0.021)、胃癌(r=-0.546,P=0.001)、结直肠癌(r=-0.362,P=0.008)的DRR与化疗疗效均呈负相关,而以TM作为评价DRR的指标则提示食管癌(r=-0.481,P=0.027)和胃癌(r=-0.361,P=0.030)与化疗疗效呈负相关,而结直肠癌(r=-0.256,P=0.064)的DRR与化疗疗效无关。结论消化道恶性肿瘤患者较健康者DNA修复能力低;DRR与晚期食管癌、胃癌患者含铂联合化疗方案的近期疗效呈负相关。Objective To investigate the relationship between the DNA repair rate( DRR) of peripheral blood lymphocytes ( PBLC) and platinum-containing chemotherapy efficacy in advanced gastrointestinal malignancies. Methods The DRR of PBLC from 112 patients with advanced gastrointestinal cancer patients( cancer group) were detected by single cell gel electrophoresis( SCGE) , and other 60 patients with healthy subjects were selected as controls( control group) . Cancer patients were treated in parallel platinum-con-taining chemotherapy regimens to evaluate the short-term effect. In cancer group, the DRR of the two platinum groups before and after exposure to platinum were analyzed. Then, the correlation between the DRR of cancer group and clinical pathological features and effi-cacy of chemotherapy regimens containing platinum was also investigated. Results Tail length( TL) and tail moment( TM) were uti-lized to detect the DRR of esophageal cancer(Z=-4.687, P=0.000; Z=-4.939, P=0.000), gastric cancer(Z=-5.473, P=0.000;Z=-3.789, P=0.000) and colorectal cancer( Z=-5.796, P=0.000;Z=-5.206, P=0.000) . The PBLC DRRs of cancer group were lower than that of control group counterpart. The PBLC DRR of cancer group exhibit no correlation to sex, age, ECOG score, alcohol habits and tissue differentiation of the tumor( P>0.05) . Among 112 patients, 110 cases were evaluable for efficacy. For esophageal cancer, there were 3 cases of PR, 6 cases of SD and 12 cases of PD with response rate( RR) of 14.3% and disease control rate( DCR) of 42.9%. For gastric cancer, there were 1 case of CR, 5 cases of PR, 10 cases of SD and 20 cases of PD with RR of 16-7% and DCR of 44.4%. For colorectal cancer, there were 2 cases of CR, 8 cases of PR, 13 cases of SD and 30 cases of PD with RR of 18.9% and DCR of 43.4%.When TL was utilized as an evaluation index of DRR, the DRR of esophageal cancer(r=-0.500, P=0.021), gastric cancer(r=-0.546, P=0.001) and colorectal cancer(r=-0.362,
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