宫颈癌k-ras基因状态在术前放化疗敏感性的临床意义  

Clinical significance of k-ras gene status in preoperative chemoradiotherapy sensitivity in cervical cancer

作　　者：徐中海 翟萍萍 张占蛟 李晓军 吕耀斗 刘光耀[2] XU Zhonghai;ZHAI Pingping;ZHANG Zhanjiao;LI Xiaojun;LYU Yaodou;LIU guangyao(Department of Pathology,Nanjing KingMed Diagnostics Institute Co.,Ltd.,Nanjing,Jiangsu 210000,China;Department of Pathology,Taizhou Hospital of Traditional Chinese Medicine,Taizhou,Jiangsu 225300,China)

机构地区：[1]南京金域医学检验所有限公司病理科,江苏南京210000 [2]泰州市中医院病理科,江苏泰州225300

出　　处：《中国优生与遗传杂志》2024年第10期2045-2052,共8页Chinese Journal of Birth Health & Heredity

摘　　要：目的探究不同宫颈癌k-ras基因状态与宫颈癌术前同步放化疗(CCRT)后病理反应程度的关系,评估宫颈癌k-ras基因对预测宫颈癌术前CCRT敏感性的价值。方法选取2018年11月至2021年2月于泰州市中医院就诊的局部晚期宫颈癌(LACC)患者104例,所有患者均给予术前NACT+RS治疗。收集患者一般资料,检测所有患者k-ras基因状态;评估患者术前CCRT效果。统计患者3年无进展生存期(PFS)、总生存期(OS)。根据患者不同k-ras基因状态,将患者分为MT组(n=21)和WT组(n=83)。采用多因素Logistic回归方程、受试者操作特征(ROC)曲线及Kaplan-Meier法进行分析。结果104例LACC样本中,共检测到83例k-ras野生型(79.81%),21例k-ras突变型(20.19%),其中以错义突变10例(47.62%)为主要突变类型。WT组患者术前CCRT敏感性明显高于MT组(P<0.05);WT组和MT组患者3年PFS率及OS率对比均具有明显差异(P<0.05);使用多因素Logistic回归方程建立预测模型,经验证显示,诊断模型具有良好的预测效能。结论LACC患者k-ras基因出现突变时,对患者术前CCRT治疗效果及远期预后、生存期产生不良影响,在LACC患者治疗过程中应对患者k-ras基因及其他临床指标进行综合评估,选取合适治疗方案。Objective The objective of this study is to investigate the relationship between k-ras gene statuses of different cervical cancer and the degree of pathological response after preoperative concurrent chemoradiotherapy(CCRT)for cervical cancer.Additionally,the value of the cervical cancer k-ras gene in predicting the susceptibility to preoperative CCRT for cervical cancer will be assessed.Methods A total of 104 patients with locally advanced cervical cancer(LACC)who attended Taizhou Hospital of Traditional Chinese Medicine from November 2018 to February 2021 were selected.All patients received preoperative NACT+RS treatment.The general data of patients was collected,and the k-ras gene status of all patients was detected,and the effect of preoperative CCRT was assessed.The three-year progression-free survival(PFS)and overall survival(OS)of patients were calculated.Patients were divided into two groups according to their different k-ras gene status:The mutant type(MT)group(n=21)and the wild-type(WT)group(n=83).The data were analysed using multifactorial Logistic regression equations,receiver operator characteristic(ROC)curves and Kaplan-Meier method.Results In 104 cases of LACC samples,83 cases of k-ras wild-type(79.81%)and 21 cases of k-ras mutant(20.19%)were detected.The main mutation type was missense mutation,with 10 cases(47.62%).The preoperative CCRT sensitivity of patients in the WT group was significantly higher than that of patients in the MT group(P<0.05).The comparison of the 3-year PFS rates and OS rates demonstrated a significant difference(P<0.05).A multifactorial Logistic regression equation was employed to establish a prediction model,and empirical evidence indicated that the diagnostic model exhibited a high degree of predictive efficacy.Conclusion Mutations in the k-ras gene of LACC patients may have a detrimental effect on the efficacy of preoperative CCRT treatment and the long-term prognosis and survival of the patients.Therefore,it is recommended that the k-ras gene and other clinical indicator

关 键 词：宫颈癌 K-RAS基因 术前同步放化疗 放化疗敏感性 临床价值 

分 类 号：R737.33[医药卫生—肿瘤]