摘要
目的研究MTHFR C677T和XRCC1 G28152A基因多态性与接受FOLFOX方案的胃肠癌患者化疗敏感性与毒副反应的关系。方法经FOLFOX方案化疗的进展期胃肠癌48例(22例有临床可观察肿瘤病灶),化疗前抽外周静脉血2 mL,用PCR-RFLP技术检测研究对象的MTHFR C677T和XRCC1 G28152A基因型。化疗两周期后全面评价疗效及毒副反应,并随访观察进展情况。结果 (1)48例胃肠癌患者,MTHFR 677 C/C、C/T、T/T基因型分别为39.6%、37.5%及22.9%。XRCC1 28152 G/G、G/A、A/A基因型分别为52.1%、45.8%及2.1%。22例可观察肿瘤病灶者MTHFR 677 C/C、C/T、T/T基因型疾病控制率分别为14.2%、66.6%和100.0%,T/T基因型明显高于C/C型(P<0.05);XRCC1 28152 G/G、G/A+A/A基因型疾病控制率分别为90.9%、36.4%,差异有统计学意义(P<0.05)。(2)48例患者带有MTHFR677 C/C、C/T、T/T基因型的2年无复发生存率分别为21.1%、36.8%和72.7%,T/T基因型明显高于C/C型(P<0.05);XRCC1 28152 G/G、G/A+A/A基因型2年无复发生存率分别为52.0%和21.7%,差异有统计学意义(P<0.05)。(3)患者接受FOLFOX方案化疗后带有MTHFR 677 C/T、T/T患者恶心/呕吐的发生率(77.8%、81.8%)明显高于C/C基因型患者(26.3%)。XRCC1 28152 G/G、G/A+A/A基因型恶心/呕吐分别为44.0%,78.3%,差异有统计学意义(P<0.05),其余毒副反应与基因型之间差异均无统计学意义(P>0.05)。结论 MTHFR C677T和XRCC1 G28152A基因多态对胃肠癌接受FOLFOX方案化疗疗效与毒性有良好的提示作用。
Objective To evaluate the relationship of the gene polymorphisms of methylenetetrahydrofolate reductase（MTHFR） C677T and X-ray cross complementing group1（XRCC1） G28152A with response to FOLFOX chemotherapy in advanced gastrointestinal cancer.Methods Blood samples were collected from 48 patients with advanced gastrointestinal cancer before treatment.PCR-RFLP was used to determine the genotypes of MTHFR C677T and XRCC1 G28152A polymorphism.All patients received FOLFOX chemotherapy;the therapeutic response and adverse effect were assessed after two cycles.Results The frequencies of MTHFR 677 C/C,C/T and T/T genotype were 39.6%,37.5% and 22.9%;the frequencies of XRCC1 28152 G/G,G/A and A/A genotype were 52.1%,45.8% and 2.1%.In 22 cases whose lesions were clinically measurable,the disease control rates in MTHFR 677 C/C,C/T and T/T genotype were 14.2%,66.6% and 100.0%,respectively（P〈0.05）.The disease control rates in XRCC1 28152 G/G,G/A＋A/A were 90.9% and 36.4%（P〈0.05）.The rates of two-year progression-free survival in patients with MTHFR 677 C/C,C/T and T/T genotype were 21.1%,36.8% and 72.7%,respectively（P〈0.05）;while the rates of two-year progression-free survival in patients with XRCC1 28152 G/G,G/A＋A/A were 52.0% and 21.7%（P〈0.05）.The complication rates of nausea/vomiting in MTHFR 677 T/T and C/T（77.8% and 81.8%） were significantly higher than those in C/C genotypes（P〈0.05）;And nausea/vomiting rate in G/G and G/A＋A/A was 44.0% and 78.3%（P〈0.05）.Conclusion The polymorphisms of MTHFR C677T and XRCC1 G28152A may be of value to predict the efficacy and adverse effect in FOLFOX chemotherapy of gastrointestinal cancer.
出处
《实用肿瘤杂志》
CAS
北大核心
2010年第4期391-395,共5页
Journal of Practical Oncology
基金
扬州大学自然科学基金资助(批准号:2006XJJ15)
