多基因联合检测指导晚期胃癌个体化化疗的临床价值  

Clinical value of combined detection of multiple genes for individualized chemotherapy in advanced gastric cancer

作　　者：周娟[1] 肖扬[1] 刘君[1] 

机构地区：[1]泰兴市人民医院肿瘤科,江苏省225400

出　　处：《江苏医药》2016年第12期1354-1358,共5页Jiangsu Medical Journal

摘　　要：目的探讨核苷酸切除修复交叉互补基因1(ERCC1)、3型β微管蛋白(TUBB3)和拓扑异构酶Ⅱα(TOPOⅡα)基因联合检测对晚期胃癌个体化化疗方案选择的指导意义。方法将70例晚期胃癌患者随机均分为研究组(A组)和对照组(B组),其中A组采用分支DNA液相芯片技术检测胃癌组织中ERCC1、TUBB3和TOPOⅡα基因表达,根据检测结果选择个体化化疗方案;B组不进行基因检测,采用三药联合方案化疗。比较两组化疗有效率、中位疾病进展时间(TTP)、中位总生存期(OS)和不良反应发生情况。结果 A组化疗有效率为66.7%,略高于B组的54.8%(P>0.05)。A组中位TTP和中位OS均较B组延长(8.0个月vs.6.6个月和12.5个月vs.9.6个月)(P<0.01)。A组血液学毒性、消化道反应、神经毒性和黏膜炎等不良反应的发生率低于B组(P<0.05)。结论ERCC1、TUBB3和TOPOⅡα基因联合检测指导的个体化化疗方案提高了晚期胃癌患者的生存质量和化疗的耐受性,在晚期胃癌的化疗中有一定的指导意义。Objective To investigate the clinical value of combined detection of excision repair cross complementing gene-1 （ ERCC1 ）, β-tubulin- Ⅲ （ TUBB3 ） and topoisomerase Ⅱα （TOPO Ⅱα） expressions for individualized chemotherapy in advanced gastric cancer. Methods A total of 70 patients with advanced gastric cancer was equally randomized into two groups of A and B. The mRNA expressions of ERCC1, TUBB3 and TOPOⅡα in the tissues of gastric cancer were detected by multiplex branched-DNA liquid chip technique, which were then taken as the basis for choosing individualized chemotherapy regimens in group A. While the patients in group B were treated with DCF regimen or ECF regimen without gene testing. The response rate, median time to progression （TTP） ,median overall survival（OS） and adverse effects were compared. Results The response rate in group A was 66.7%, which was slightly higher than 54.8% in group B（P〉0. 05）. Compared with group B, the median TTP and median OS were prolonged in group A（8.0 months vs. 6.6 months and 12.5 months vs. 9.6 months）（P〈0. 01）. The incidence rate of adverse effects including hematological toxicity,gastrointestinal reaction,neurotoxicity and mucositis in group A was lower than that in group B（P〈0. 05）. Conclusion Combined detection of ERCC1, TUBB3 and TOPO Ⅱα expressions plays a guidance role in making individualized chemotherapy, which improves the quality of life and tolerance of chemotherapy in the patients with advanced gastric cancer.

关 键 词：晚期胃癌 核苷酸切除修复交叉互补基因1 3型β微管蛋白 拓扑异构酶Ⅱα 个体化化疗 

分 类 号：R735[医药卫生—肿瘤]