基于多基因多态性的风险划分与一线含铂药物化疗晚期非小细胞肺癌患者生存的关系  

Association between Risk Rank According to Polymorphisms of Multiple Genes and Survival of Advanced Non-small-cell Lung Cancer Patients Receiving Platinum-based First-line Chemotherapy

作　　者：刘勇[1] 孟令占[1] 刘娜[1] 罗玲[1] 艾亮[1] 朱江红[1] 王静[1] 刘文琴[1] 程俊[1] Liu Yong;Meng Lingzhan;Liu Na(Department of Oncology,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院肿瘤科,重庆400021

出　　处：《华中科技大学学报（医学版）》2018年第4期473-478,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：重庆市卫生计生委医学科研基金项目(No.20143007)

摘　　要：目的晚期非小细胞肺癌(NSCLC)患者接受一线含铂药物化疗方案时,疗效和预后受到多个基因多态性的影响。该研究旨在分析铂类药物化疗不利基因型的数量与生存的关系。方法采用xTAG-液相芯片方法,检测63例NSCLC患者一线含铂药物化疗前血液中切除修复交叉互补基因1(ERCC1)、ERCC2、X线交叉互补基因1(XRCC1)、谷胱甘肽S-转移酶P1(GSTP1)、谷胱甘肽S-转移酶M1(GSTM1)及凋亡调节蛋白BIM基因多态性分布,分析单个位点与预后的相关性。根据铂类药物化疗预后不利位点出现的数量,将患者划分为低风险(≤2个),中风险(3~4个)和高风险(≥5个)。结果单个基因位点与中位无进展生存期(PFS)和总生存期(OS)有相关性,但鲜少达到显著水平。风险划分后,低、中、高风险组的中位PFS分别为6.8、5.5和4.0个月,P=0.001;中位OS分别为14.9、11.5和9.4个月,P=0.010。结论对于接受一线含铂药物化疗的晚期非小细胞肺癌患者来说,基于多个基因多态性的风险划分能够有效预测PFS和OS。Objective The therapeutic effect and prognosis of advanced non-small-cell lung cancer（NSCLC）patients who received platinum-based first-line chemotherapy were greatly affected by polymorphisms of multiple genes.This study focused on the relationship between number of unfavorable genotypes and survival.Methods xTAG liquidchip was used to detect the SNP of excision repair cross complementation gene 1（ERCC1）,ERCC2,X-ray repair cross complementing 1（XRCC1）,glutathione S-transferase P1（GSTP1）,glutathione S-transferase M1（GSTM1）and BIM（Bcl-2 interacting mediator of cell death）from blood of 63 NSCLC patients treated with platinum-based regimens as first-line chemotherapy.The relationship between survival and single polymorphism was explored.Patients were categorized as having a low（≤2）,intermediate（3-4）,or high risk（≥ 5）according to the number of unfavorable genotypes after platinum-based chemotherapy.Results Polymorphism of all 7 sites was associated with median PFS and OS,but few were statistically significant.In addition,the Kaplan-Meier estimates of the median PFS in the low-risk,intermediate-risk,and high-risk groups were 6.8 months,5.5 months and 4.0 months,respectively（P=0.001）.The median OS of those groups were 14.9 months,11.5 months,9.4 months,respectively（P=0.010）.ConclusionOur results suggest that risk rank according to polymorphisms of multiple genes could effectively predict PFS and OS in NSCLC patients receiving platinum-based first-line chemotherapy.

关 键 词：非小细胞肺癌 铂类 多态性 多基因 

分 类 号：R734.2[医药卫生—肿瘤]