摘要
目的 探讨GSTA1基因多态性与接受CTX类药物辅助化疗乳腺癌患者预后的关系.方法 对采用CTX类药物为主的方案进行辅助化疗的137例确诊乳腺癌患者（浸润性导管癌患者124例,浸润性小叶癌患者5例,其他类型癌症患者8例）,用PCR-LDR检测其GSTA1基因多态性,Kaplan-Meier法绘制生存曲线,log-rank法比较不同基因型组间生存差异,并用Cox比例风险回归模型进行预后影响因素的多因素分析.结果 137例乳腺癌患者中,GSTA1＊A/＊A、＊A/＊B和-B/＊B基因型频率分别为67.2%（92/137）、31.4%（43/137）和1.5%（2/137）.乳腺癌患者的GSTA1基因型频率在按年龄、临床分期、淋巴结转移、雌、孕激素受体状态等临床病理特征分组的分布差异均无统计学意义（x2值分别为0.722、1.967、3.303、0.226、0.709,P均＞0.05）;经Fisher精确概率分析,肿瘤大小、病理组织类型、病理分级的差异均无统计学意义（P均＞0.05）.携带GSTA1-A/＊A基因型和＊A/＊B或＊B/-B基因型的乳腺癌患者复发率分别为47.8%（44/92）和31.1%（14/45）,死亡率分别为22.8%（21/92）和17.8%（8/45）.Kaplan-Meier生存曲线和log-rank分析显示,携带GSTA1＊A/＊B＋＊B/＊B基因型乳腺癌患者的无复发生存率和总生存率均高于携带GSTA1＊A/＊A基因型患者,且差异均有统计学意义（x2值分别为18.723、7.352,P均＜0.01）.经Cox多因素分析,GSTA1基因多态性是影响乳腺癌患者无复发生存[OR=0.222,95%CI：0.108～0.458,P＜0.01]和总生存[OR=0.362,95%CI：0.145～0.902,P＜0.05]的独立因素.结论 GSTA1基因多态性是乳腺癌患者CTX药物辅助化疗无复发生存和总生存的预测标志.
Objective To investigate the association between the genetic polymorphisms in GSTA1 and the clinical outcome of breast cancer patients treated with cyclophosphamide-based adjuvant chemotherapy. Methods A total of 137 breast cancer patients receiving cyclophosphamide-based adjuvant chemotherapy were recruited （ 124 cases with infiltrative ductal carcinoma, 5 cases with infiltrative lobular carcinoma and 8 cases with other histological types）. PCR-LDR method was used to detect the genotypes of GSTA1. Survival curves were generated by the Kaplan-Meier method, and verified by the log-rank test. Cox proportional hazards regression analysis was used to estimate the prognostic factors in multivariate analysis. Results Of the 137 breast cancer patients, the genotypic frequencies of the GSTA1 ＊ A/＊ A,＊ A/＊ B and ＊ B/＊ B were 67.2% （ 92/137 ）, 31.4% （ 43/137 ） and 1.5% （ 2/137 ）, respectively. No significant differences were found between the genotypic frequencies and groups categorization according to age, stage, lymph node metastasis, ER or PR status （x2 = 0. 722,1. 967, 3. 303, 0. 226 and 0. 709, all P ＞0. 05 ） ;through Fisher exact test, also no significant differences were found between the genotypic frequencies and group categorization according to tumor size, histological types and grading （ all P ＞ 0. 05 ） . The recurrence rates in patients with GSTA1 ＊ A/＊ A and ＊ A/＊ B or ＊ B/＊ B genotypes were 47. 8% （44/92） and 31.1% （ 14/45 ）, respectively, and the mortality rates were 22. 8% （ 21/92 ） and 17. 8% （ 8/45 ）,respectively. Patients with GSTA1 ＊ A/＊ B and ＊ B/＊ B genotypes were significantly associated with reduced hazard of relapse （x2 =18.723, P＜0. 01）and mortality （x2 =7.352, P＜0.01）, compared to cases with the common ＊ A/＊ A genotypes, according to Kaplan-Meier survival analysis and log-rank test. Moreover,Cox multivariate analysis showed that GSTA1 polymorphisms appeared to be an independent risk factor for recurrence-f
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2011年第4期309-314,共6页
Chinese Journal of Laboratory Medicine
基金
无锡市社会发展计划资助课题（CSE00708）
无锡市科技发展计划（333工程）资助课题（CAE 00801-08）
