BIM基因多态性与阿美替尼二线治疗晚期非小细胞肺癌疗效的相关性  

Correlation between BIM gene polymorphism and the efficacy of second-line treatment with almonertinib in advanced non-small cell lung cancer

作　　者：武献珍 范晓卿[2] 原琦 WU Xianzhen;FAN Xiaoqing;YUAN Qi(Comprehensive special needs ward,Shanxi Cancer Hospital Cancer Hospital of Chinese Academy of Medical Sciences Shanxi Hospital Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan,Shanxi 030001,China;Clinical Laboratory,Shanxi Cancer Hospital Cancer Hospital of Chinese Academy of Medical Sciences Shanxi Hospital Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan,Shanxi 030001,China;Gastroenterology Department,Shanxi Cancer Hospital Cancer Hospital of Chinese Academy of Medical Sciences Shanxi Hospital Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan,Shanxi 030001,China)

机构地区：[1]山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院综合特需病房,山西太原030001 [2]山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院检验科,山西太原030001 [3]山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院消化科,山西太原030001

出　　处：《临床肺科杂志》2025年第4期497-504,共8页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨BIM基因多态性与阿美替尼二线治疗晚期非小细胞肺癌疗效的相关性。方法选取2020年4月至2022年4月我院收治的100例晚期非小细胞肺癌(NSCLC)患者,均接受阿美替尼二线治疗,根据疗效情况分为无效组(n=48)和有效组(n=52)。采用TaqMan探针进行基因分型。对比分析两组患者临床资料、基因型以及等位基因分析情况,并分析两组血清因子水平差异;多变量Cox回归模型分析患者疗效的影响因素;采用线性回归分析BIM基因多态性与血清因子的关联;并采用Kaplan-Meier绘制生存曲线。结果无效组CC、CT基因频率以及C等位基因频率均显著高于有效组(P<0.05);两组患者在血栓病史、性别、病理类型、吸烟、受教育程度、转移部位、PS评分、CRP方面差异有统计学意义(P<0.05);两组患者治疗前bFGF、VEGF、PTX3、CCL20水平比较均无显著性差异(P>0.05),治疗后,有效组bFGF、VEGF、PTX3、CCL20水平显著低于无效组,且显著低于治疗前(P<0.05),而无效组bFGF、VEGF、PTX3、CCL20水平与治疗前比较无显著性差异(P>0.05);多变量Cox回归分析结果显示,PS评分、吸烟、病理类型、BIM基因(rs724710)C等位基因是阿美替尼二线治疗晚期NSCLC患者疗效的独立危险因素(P均<0.05);线性回归分析结果显示BIM基因(rs724710)与患者bFGF、VEGF、PTX3、CCL20水平显著关联(P<0.05),且bFGF、VEGF、PTX3以及CCL20均与BIM基因(rs724710)多态性存在交互作用;BIM基因(rs724710)基因CC型(31.25%)患者OS率显著低于CT型(69.75%,χ^(2)=5.574,P=0.018)和TT型(77.78%,χ^(2)=4.996,P=0.025)。结论BIM基因(rs724710)多态性与阿美替尼二线治疗晚期NSCLC患者疗效密切相关,且与bFGF、VEGF、PTX3、CCL20存在交互作用,临床可通过检测晚期NSCLC患者BIM基因多态性评估其疗效。Objective To explore the correlation between BIM deletion polymorphism and the efficacy of second-line treatment with almonertinib in advanced non-small cell lung cancer.Methods 100 patients with advanced non-small cell lung cancer(NSCLC)admitted to our hospital from April 2020 to April 2022 were selected,all of whom received second-line treatment with almonertinib.They were divided into the ineffective group(n=48)and the effective group(n=52)based on their efficacy.It used TaqMan probe for genotyping.Their clinical data,genotype,and allele gene analysis were compared between the two groups,and the differences in serum factor levels were also analyzed between the two groups.It used a multivariate Cox regression model to analyze the influencing factors of patient efficacy,linear regression analysis to investigate the association between BIM gene polymorphism and serum factors,and Kaplan Meier to plot the survival curve.Results The frequency of CC,CT genes,and C alleles in the ineffective group was significantly higher than that in the effective group(P<0.05).There were statistically significant differences in gender,smoking,education level,site of metastasis,history of thrombosis,PS score,pathological type,and CRP(P<0.05)between the two groups.There was no significant difference in the levels of bFGF,VEGF,PTX3,and CCL20 between the two groups before treatment(P>0.05).After treatment,the levels of bFGF,VEGF,PTX3,and CCL20 in the effective group were significantly lower than those in the ineffective group,and significantly lower than before treatment(P<0.05).However,there was no significant difference in the levels of bFGF,VEGF,PTX3,and CCL20 between the ineffective group and before treatment(P>0.05).The results of multivariate Cox regression analysis showed that PS score,smoking,pathological type,BIM gene(rs724710),and CC gene were independent risk factors for the efficacy of second-line treatment with almonertinib in advanced NSCLC patients(P<0.05).The results of linear regression analysis showed that the BIM gene

关 键 词：阿美替尼 BIM基因多态性 非小细胞肺癌 疗效 相关性 

分 类 号：R734.2[医药卫生—肿瘤]