XRCC1 TYMS MTHFR基因多态性与结肠癌术后辅助化疗疗效的关系  

The Relationship Between XRCC1 TYMS MTHFR Gene Polymorphisms and the Efficacy of Adjuvant Chemotherapy After Colon Cancer Surgery

作　　者：赵帅[1] 陈静[1] 闫海洋 郭英[1] 孙静娜[1] 耿玉兰[1] 刘佳佳[1] ZHAO Shuai;CHEN Jing;YAN Haiyang(The First Hospital of Hebei Medical University, Hebei Shijiazhuang 050031, China)

机构地区：[1]河北医科大学第一医院检验中心,河北石家庄050031

出　　处：《河北医学》2022年第5期750-754,共5页Hebei Medicine

基　　金：河北省卫生健康委员会科研基金项目,(编号:20190481)。

摘　　要：目的:探究与分析Ⅱ、Ⅲ期结肠癌术后行FOLFOX4辅助化疗的疗效,同时分析X线修复交叉互补基因I(XRCC1)、TYMS、亚甲基四氢叶酸还原酶(MTHFR)基因多态性与疗效之间关系,旨在寻找及分析辅助化疗的预测因子。方法:回顾性分析我院自2018年5月至2020年1月收治的手术治疗结束后接受6个周期FOLFOX4辅助化疗患者104例的临床资料,治疗后判断随访2年无病生存率并将其作为疗效评价标准。全部患者的肿瘤组织标本均提取了DNA,并对XRCC1、TYMS、MTHFR基因型进行检测。采用卡方检验对比不同基因型之间的复发率,之后采用COX回归模型探讨可能对疗效造成影响的因素。结果:XRCC1、TYMS、MTHFR基因型分布中分别以G/A基因型、2R/3R基因型、T/C基因型为主,要明显高于其他基因类型,差异有统计学意义(P<0.05)。XRCC1基因型分布为G/A者,其随访2年内复发率要明显高于G/G基因型、A/A基因型,差异有统计学意义(P<0.05)。将COX模型单因素分析结果有明显差异的单因素纳入到多因素模型中,XRCC1基因多态性与结肠癌术后行FOLFOX4辅助化疗后2年内无病生存率造成直接影响(P<0.05)。行COX模型单因素分析结果显示,TNM分期、肠壁浸润、XRCC1与结肠癌术后FOLFOX4辅助化疗具有相关性(P<0.05)。结论:XRCC1基因多态性与结肠癌术后行FOLFOX4辅助化疗后2年内无病生存率造成直接影响,二者具有直接相关性,通过对XRCC1基因多态性进行检测可作为预测Ⅱ、Ⅲ期结肠癌术后行FOLFOX4辅助化疗疗效的可靠指标。Objective:To investigate and analyse the efficacy of adjuvant chemotherapy with FOLFOX4 after surgery for stage II and III colon cancer,and to analyse the relationship between X ray repair cross complementary gene I(XRCC1),TYMS,methylenetetrahydrofolate reductase(MTHFR)gene polymorphisms and efficacy,with the aim of finding and analysing the predictors of adjuvant chemotherapy.Methods:The clinical data of 104 patients who received 6 cycles of FOLFOX4 adjuvant chemotherapy after the end of surgical treatment admitted to our hospital from May 2018 to January 2020 were retrospectively analyzed,and the 2-year disease-free survival rate was judged at follow-up after treatment and used as an efficacy evaluation criterion.DNA was extracted from tumour tissue specimens of all patients,and XRCC1,TYMS and MTHFR genotypes were tested.A chi-square test was used to compare the recurrence rates between genotypes,followed by a COX regression model to explore factors that might have an impact on the efficacy.Results:The genotype distribution of XRCC1,TYMS and MTHFR was dominated by G/A genotype,2R/3R genotype and T/C genotype respectively,which were significantly higher than the other genotypes,and the difference was statistically significant(P<0.05).The difference was statistically significant(P<0.05).The XRCC1 gene polymorphism had a direct effect on the disease-free survival rate at 2 years after FOLFOX4 adjuvant chemotherapy for colon cancer(P<0.05).The results of the univariate analysis of the COX model showed that TNM stage,intestinal wall infiltration,XRCC1 and adjuvant chemotherapy with FOLFOX4 after surgery for colon cancer were correlated(P<0.05).Conclusion:The XRCC1 gene polymorphism has a direct correlation with disease free survival at 2 years after FOLFOX4 adjuvant chemotherapy for colon cancer.Detection of XRCC1 polymorphism can be used as a reliable predictor of the efficacy of adjuvant chemotherapy with FOLFOX4 after surgery for stage II and III colon cancer.

关 键 词：XRCC1 TYMS MTHFR 基因多态性 结肠癌 辅助化疗 预测 

分 类 号：R73[医药卫生—肿瘤]