UGT1A1基因多态性联合外周血循环肿瘤细胞检测对结直肠癌术后转移的预测价值探讨  

Prognostic value of UGT1A1 gene polymorphism combined with peripheral blood CTC detection in postoperative metastasis or recurrence of colorectal cancer

作　　者：李圣平 尚超 胡建平 Li Shengping;Shang Chao;Hu Jianping(Department of General Surgery,The Affliated Jiangning Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属医院江宁医院普外科,210000

出　　处：《中华转移性肿瘤杂志》2021年第2期144-149,共6页Chinese Journal of Metastatic Cancer

摘　　要：目的探讨UGT1A1基因多态性联合外周血循环肿瘤细胞(CTC)检测对结直肠癌术后转移的预测价值。方法选取我院2018—2019年间收治的120例行结直肠癌根治术并进行UGT1A1基因多态性和外周血CTC检测的患者作为研究对象,根据在随访期间内是否发生肿瘤复发或远处转移,将患者分为复发转移组和非复发转移组。通过Logistic回归分析UGT1A1基因多态性和外周血CTC与结直肠癌术后转移的相关性,并采用ROC曲线对其诊断效能进行评价。结果120例患者中术后46例发生复发或转移。单因素分析发现复发转移组UGT1A1*28基因突变(包括杂合突变和纯合突变)和外周血CTC数目≥2个/7.5ml患者比例分别为37.0%和56.5%,明显高于未复发转移组的18.9%和36.5%(P<0.05)。Logistic回归分析提示患者UGT1A1*28基因突变(OR=4.097,95%CI为1.634~10.273)及外周血CTC数目≥2个/7.5ml(OR=0.454,95%CI为0.241~0.855)是结直肠癌术后复发或转移的独立危险因素(P<0.05)。UGT1A1*28基因多态性和外周血CTC水平ROC曲线的AUC值分别为0.787和0.781,而两者联合预测概率AUC为0.902,相较于单个指标显著提升(P<0.01)。结论UGT1A1*28基因多态性检测结合外周血CTC水平显著提高对结直肠癌术后患者复发或转移的预测价值,具有较高的临床应用前景,值得进一步推广使用。Objective To explore the predictive value of UGT1A1 gene polymorphism combined with peripheral blood circulating tumor cell(CTC)detection for postoperative metastasis of colorectal cancer.Methods A total of 120 patients who underwent radical colorectal cancer surgery were performed by UGT1A1 gene polymorphism and blood CTC detection in our hospital from January 2018 to December 2019 that were selected as the research.Based on tumor recurrence or distant metastasis,the patients were divided into relapse,metastasis group,non-relapse and metastasis group.Logistic regression was used to analyze the correlation among UGT1A1 gene polymorphism and CTC and colorectal cancer postoperative metastasis,and the ROC curve was used to evaluate its diagnostic efficacy.Results Of the 120 patients,46 had recurrence or metastasis after surgery.Univariate analysis found that the proportion of patients with UGT1A1*28 gene mutations(including heterozygous mutations and homozygous mutations)and the number of peripheral blood CTCs in the recurrence and metastasis group were 37.0%and 56.5%,respectively,which were significantly higher than those without recurrence.In 18.9%and 36.5%of the metastasis group,the results were statistically different(P<0.05).Logistic regression analysis indicated that the UGT1A1*28 gene mutation(OR=4.097,95%CI:1.634~10.273)and the number of peripheral blood CTCs≥2/7.5ml(OR=0.454,95%CI:0.241~0.855)were the independent risk factors for recurrence or metastasis of colorectal cancer after operation,and their differences were statistically significant(P<0.05)between the two groups.The UGT1A1*28 gene polymorphism and blood CTC level ROC curve AUC values were 0.787 and 0.781,respectively,and the combined prediction probability of the two AUC was 0.902,which was significantly improved compared to a single indicator,that the results were statistically significant(P<0.01).ConclusionUGT1A1*28 gene polymorphism detection combined with peripheral blood CTC level significantly improves the predictive value of recurrence or

关 键 词：UGT1A1基因 外周血肿瘤循环细胞 结直肠癌 预测价值 

分 类 号：R73[医药卫生—肿瘤]