MTHFR基因多态性协同血清ANG2表达对雌激素受体阳性乳腺癌化疗疗效的预测价值  

Predictive value of MTHFR gene polymorphism in collaboration with serum ANG2 expression in chemotherapy for estrogen receptor-positive breast cancer

作　　者：殷力佳 陈惕[1] 张建[1] Yin Lijia;Chen Ti;Zhang Jian(Oncology Department,Changshu City First People’s Hospital,Suzhou 215500,China)

机构地区：[1]常熟市第一人民医院肿瘤科,苏州215500

出　　处：《中华内分泌外科杂志（中英文）》2024年第5期643-647,共5页Chinese Journal of Endocrine Surgery

基　　金：江苏省自然科学基金(BK20191172)。

摘　　要：目的探究甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)基因多态性协同血清血管生成素2(angiopoietin 2,ANG2)表达对雌激素受体(estrogen receptor,ER)阳性乳腺癌化疗疗效的预测价值。方法选取常熟市第一人民医院2017年3月至2022年3月期间收治的66例进行化疗的ER阳性乳腺癌患者,根据患者化疗疗效分为有效组及无效组。收集两组患者临床资料,并于化疗前采用PCR法检测白细胞DNA中的MTHFR基因多态性,同时检测患者血清ANG2表达情况。比较两组患者的一般资料、MTHFR基因多态性及ANG2水平,Logistic回归分析影响ER阳性乳腺癌化疗疗效的因素,根据受试者工作特征(receiver operating characteristic,ROC)曲线分析MTHFR基因多态性协同ANG2水平对ER阳性乳腺癌化疗疗效的预测价值。结果66例ER阳性乳腺癌化疗后完全缓解(complete remission,CR)11例,部分缓解(partial remission,PR)38例,疾病稳定(stable disease,SD)10例,疾病进展(progression of disease,PD)7例。无效组淋巴转移人数占比、C677T型MTHFR基因中CC占比及血清ANG2水平高于有效组(P<0.05)。经Logistic回归分析,淋巴转移情况、C677T型MTHFR基因及ANG2水平是ER阳性乳腺癌化疗疗效的独立危险因素(P<0.05)。经ROC分析显示,C677T型MTHFR基因、ANG2预测ER阳性乳腺癌化疗疗效的曲线下面积(area under curve,AUC)值分别为0.779,0.726,95%CI为0.660~0.872,0.596~0.824,二者联合预测的AUC值为0.920,95%CI为0.826~0.972。结论C677T型MTHFR基因多态性、ANG2水平对于ER阳性乳腺癌化疗疗效均有一定的参考价值,二者协同用于预测ER阳性乳腺癌化疗疗效的价值更高。ObjectiveTo explore the predictive value of methyltetrahydrofolate reductase(MTHFR)gene polymorphism in collaboration with serum ANG2 expression on the efficacy of estrogen receptor(ER)positive breast cancer chemotherapy.MethodsSixty-six patients with ER-positive breast cancer who underwent chemotherapy were selected from Changshu First People’s Hospital from Mar.2017 to Mar.2022.According to the efficacy of chemotherapy,patients were divided into effective group and ineffective group.Clinical data of two groups of patients were collected,and PCR was used to detect MTHFR gene polymorphisms in leukocyte DNA and ANG2 expression in serum of patients before chemotherapy.The general data,MTHFR gene polymorphism and ANG2 level of the two groups were compared,and the factors influencing the efficacy of chemotherapy for ER-positive breast cancer were analyzed by Logistic regression.The predictive value of MTHFR gene polymorphism and ANG2 level in ER-positive breast cancer chemotherapy was analyzed according to receiver operating characteristic(ROC)curve.ResultsThere were 11 complete responses(CR),38 partial responses(PR),10 stable disease(SD),and 7 progressive disease(PD)after chemotherapy in 66 ER-positive breast cancer patients.The proportion of lymphatic metastases,the proportion of CC in C677T MTHFR gene and the level of ANG2 in serum in the ineffective group were higher than those in the effective group(P<0.05).Logistic analysis showed that lymph metastases,C677T MTHFR gene and ANG2 level were independent risk factors for chemotherapy efficacy of ER-positive breast cancer by Logistic regression analysis(P<0.05).ROC analysis showed that the area under the curve(AUC)values of C677T MTHFR gene and ANG2 in predicting the efficacy of chemotherapy for ER-positive breast cancer were 0.779 and 0.726,respectively,and 95%CI were 0.660-0.872 and 0.596-0.824.The combined predicted AUC value was 0.920,and 95%CI was 0.826-0.972.ConclusionsMTHFR gene polymorphism and ANG2 level are of reference value for chemotherapy efficacy of

关 键 词：MTHFR基因多态性 促血管生成素2 雌激素受体阳性 乳腺癌 化疗疗效 

分 类 号：R737.9[医药卫生—肿瘤]