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目的:探讨XRCC1基因多态性与中晚期胃癌新辅助化疗敏感相关性。方法:将77例中晚期胃癌患者随机分为新辅助化疗组(36例)和常规手术对照组(41例),所有患者均行手术治疗,并经术后病理确诊。采用荧光直接测序法测定XRCC1 399位点多态性与中晚期胃癌新辅助化疗疗效的关系。结果:新辅助化疗组肿瘤细胞坏死率(35.60%)明显高于对照组(3.52%)。新辅助化疗组A/A(55.82%)肿瘤细胞坏死率明显高于A/G(32.13%)及G/G(9.17%)的肿瘤细胞坏死率。新辅助化疗组的组织学有效率为41.70%。通过观察化疗前后的CT图片并结合术中探查,新辅助化疗组患者CR 2例(5.60%),PR 15例(41.60%),SD 14例(38.90%),PD 5例(13.90%),总反应率为47.20%。新辅助化疗组根治性手术切除率(80.56%)明显高于对照组(58.54%),P=0.037。结论:中晚期胃癌新辅助化疗组XRCC1基因399位点A/A多态性与肿瘤细胞坏死率存在相关性,可以作为中晚期胃癌新辅助化疗敏感性的基因水平预测指标。
Objective: To investigate the relationship between polymorphism of XRCC1 gene and neoadjuvant chemotherapy in advanced gastric cancer. Methods: A total of 77 patients with advanced gastric cancer were randomly divided into neoadjuvant chemotherapy group (n = 36) and conventional surgery control group (n = 41). All patients underwent surgical treatment and confirmed by postoperative pathology. Relationship between the polymorphism of XRCC1 399 locus and the efficacy of neoadjuvant chemotherapy in advanced gastric cancer by fluorescence direct sequencing. Results: The tumor necrosis rate (35.60%) in neoadjuvant chemotherapy group was significantly higher than that in control group (3.52%). Necrosis chemotherapy group A / A (55.82%) tumor necrosis rate was significantly higher than the A / G (32.13%) and G / G (9.17%) of the tumor cell necrosis rate. The neoadjuvant chemotherapy group histological efficiency was 41.70%. In the neoadjuvant chemotherapy group, CR 2 (5.60%), PR 15 (41.60%), SD 14 (38.90%) and PD 5 (13.90%) were observed before and after chemotherapy. The overall response rate was 47.20%. The neoadjuvant chemotherapy group, radical resection rate (80.56%) was significantly higher than the control group (58.54%), P = 0.037. Conclusion: There is a correlation between A / A polymorphism of XRCC1 gene 399 loci and neoplastic cell necrosis rate in neoadjuvant chemotherapy for advanced gastric cancer, which can be used as a predictor of gene sensitivity for neoadjuvant chemotherapy in advanced gastric cancer.