摘要
目的探讨X射线修复交叉互补1(XRCC1)Arg399Gln基因多态性对进展期胃癌D2根治术后SOX方案(奥沙利铂130 mg/m^(2)静脉滴注第1天,替吉奥40 mg/m^(2)口服2次/d,第1~14天,每21 d重复)化疗的不良反应及预后的预测价值。方法回顾性分析2015年1月至2018年4月在衢州市人民医院胃肠外科收治的62例进展期胃癌D2根治术后实施SOX方案辅助化疗患者的临床资料。收集术后病理标本行XRCC1 Arg399Gln多态性基因分型检测,分析XRCC1 Arg399Gln多态性与胃癌术后患者的临床病理特征、化疗不良反应发生的关系,并比较不同基因亚型的无病生存期(DFS)及总生存期(OS),Cox回归分析筛选预后危险因素。结果62例胃癌患者中XRCC1 Arg399Gln基因亚型分布分别为G/G型35例(56.45%),G/A型21例(33.87%)及A/A型6例(9.68%),XRCC1 Arg399Gln基因亚型分布符合Hardy-Weinberg遗传平衡定律(P=0.295)。后续的分析将G/A型和A/A型合并,G/G型和G/A+A/A型患者的临床资料分布均衡,不同基因亚型与SOX方案辅助化疗的各项不良反应无相关性。XRCC1 Arg399Gln位点G/G基因型与G/A+A/A基因型的中位DFS分别为45个月(95%CI 41.73~48.28)和38个月(95%CI 35.71~40.29),差异有统计学意义(P=0.047);单因素Cox回归分析显示XRCC1 Arg399Gln多态性(RR=2.178,95%CI 1.078~4.402,P=0.030)是进展期胃癌术后行SOX方案化疗患者肿瘤复发的危险因素;多因素Cox回归及校正分析显示,XRCC1 Arg399Gln多态性(RR=2.581,95%CI 1.242~5.363,P=0.011)是进展期胃癌术后实施SOX方案化疗患者肿瘤复发的独立危险因素。XRCC1 Arg399Gln位点G/G基因型与G/A+A/A基因型的中位OS分别为60个月(95%CI 57.81~62.19)和55个月(95%CI 49.62~60.38),差异无统计学意义(P=0.202);单因素Cox回归分析显示XRCC1 Arg399Gln多态性(RR=1.702,95%CI 0.744~3.896,P=0.208)不是进展期胃癌术后实施SOX方案化疗患者死亡的危险因素。结论XRCC1 Arg399Gln基因多态性与进展期胃癌术后SOX方案化疗的不良反�
Objective To investigate the predictive value of XRCC1 Arg399Gln gene polymorphism in the adverse events and prognosis of SOX chemotherapy for advanced gastric cancer after D2 resection.Methods A total of 62 patients with advanced gastric cancer receiving Sox chemotherapy after D2 resection from January 2015 to April 2018 in Quzhou People′s Hospital were included and the baseline characteristics were collected retrospectively.Postoperative pathological specimens were used for genotyping of XRCC1 Arg399Gln gene variation.To analyze the relationship between the polymorphism of XRCC1 Arg399Gln in patients and the clinicopathological features and the occurrence of adverse chemotherapy reactions.Also,to evaluate the disease-free survival(DFS)and overall survival(OS)of patients in the different genotypes.Cox regression analysis was used to screen for prognostic risk factors.Results The genotype distribution of XRCC1 Arg399Gln locus in 62 patients with gastric cancer was G/G in 35 cases(56.45%),G/A in 21 cases(33.87%)and A/A in 6 cases(9.68%).And the distribution frequencies of the three genotypes were in accordance with the hardy-weinberg equilibrium(P=0.295).G/A and A/A genotypes were merged in the subsequent analysis.Comparison of baseline characteristics between the G/G genotype and G/A+A/A genotype showed no statistically significant differences(all P>0.05).Different genotypes had no significant differences in the adverse reactions of Sox chemotherapy after advanced gastric cancer surgery(all P>0.05).The median DFS of the G/G genotype was 45 months(95%CI 41.73-48.28),which was higher than G/A+A/A genotype 38 months(95%CI 35.71-40.29)(P=0.047).Univariate Cox regression analysis showed that the polymorphism of XRCC1 Arg399Gln was risk factor for tumor recurrence in patients with advanced gastric cancer who received SOX chemotherapy after surgery(RR=2.178,95%CI 1.078-4.402,P=0.030).Multivariate Cox regression analysis showed that the polymorphism of XRCC1 Arg399Gln was independent risk factor for tumor recurrence in
作者
郑临海
钱军
韩少良
Zheng Linhai;Qian Jun;Han Shaoliang(Department of Gastrointestinal Surgery,the Quzhou Affiliated Hospital of Wenzhou Medical University,Quzhou People′s Hospital,Quzhou 324000,China;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325035,China)
出处
《中国医师进修杂志》
2023年第10期865-870,共6页
Chinese Journal of Postgraduates of Medicine
基金
衢州市科技计划竞争性项目(2020065)。
关键词
胃肿瘤
基因
X射线修复交叉互补1
多态性
奥沙利铂
Stomach neoplasms
Gene
X-ray repair cross complementing 1
Polymorphism
Oxaliplatin
