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目的探讨RRM1基因多态性与非小细胞肺癌患者吉西他滨联合顺铂化疗效果及临床预后的关系。方法回顾性分析2015年6月-2016年6月在本院收治的非小细胞肺癌患者80例,所有患者均采用GP方案化疗,在化疗前均抽取外周血检测患者RRM1多态性,记录患者化疗效果,探讨RRM1基因多态性与患者化疗敏感性的关系,并采用Logistic回顾模型探讨RRM1基因多态性与非小细胞肺癌患者临床预后的关系。结果 80例患者出现的不良反应发病率为白细胞减少51.9%、胃肠道症状(恶性呕吐)48.1%、肝功能异常18.5%、外周神经毒性51.9%,各不良反应以Ⅰ度为主。80例患者中CR 10例、PR 13例、SD 34例、PD 23例,RRM1*27(A/A)、RRM1*524(T/T)缓解率高于其他基因型患者,差异有统计学意义(P<0.05)。肿瘤N分期、RRM1*27(C/C)、RRM1*524(C/C)是非小细胞肺癌患者死亡、转移或复发的独立危险因素(P<0.05)。结论 RRM1基因型与患者化疗效果及预后明显相关,值得临床关注。
Objective To investigate the relationship between RRM1 gene polymorphism and chemotherapy efficacy and clinical outcome of gemcitabine and cisplatin in patients with non-small cell lung cancer. Methods 80 patients with non-small cell lung cancer admitted to our hospital from June 2015 to June 2016 were retrospectively analyzed. All of the patients were treated with GP regimen. The RRM1 polymorphisms in peripheral blood were collected before chemotherapy. The patients were recorded To investigate the relationship between RRM1 gene polymorphism and chemosensitivity in patients and to investigate the relationship between RRM1 gene polymorphism and clinical prognosis in patients with non-small cell lung cancer using Logistic regression model. Results The incidence of adverse reactions in 80 patients was 51.9% for leukopenia, 48.1% for gastrointestinal symptoms (malignant vomiting), 18.5% for liver dysfunction, and 51.9% for peripheral neurotoxicity. The main adverse reactions were Ⅰ degree. Among the 80 patients, there were 10 cases of CR, 13 cases of PR, 34 cases of SD, 23 cases of PD, RRM1 * 27 (A / A) and RRM1 * 524 (T / T) were significantly higher than those of other genotypes Significance (P <0.05). The N stage, RRM1 * 27 (C / C) and RRM1 * 524 (C / C) were independent risk factors of death, metastasis or recurrence in patients with non-small cell lung cancer (P <0.05). Conclusion The genotype of RRM1 is significantly correlated with the efficacy and prognosis of patients with chemotherapy, which deserves clinical attention.