论文部分内容阅读
目的:探索非小细胞肺癌(non-small cell lung cancer,NSCLC)患者亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)基因C677T多态性与培美曲塞联合顺铂化疗疗效的关系。方法:选取88例(NSCLC)患者入组,化疗前抽取患者外周血液,通过Taqman MGB探针实时荧光定量PCR方法检测患者MTHFR677C/T位点的基因多态性,并分析其与化疗疗效的关系。结果:所有患者中,MTHFR基因C677T野生型(CC)的分布为61.4%(54/88),纯合突变型(TT)为13.6%(12/88),杂合突变型(CT)为25.0%(22/88)。使用培美曲塞/顺铂化疗方案的疗效:野生型(CC)PR18例,SD19例,PD17例,总有效率(ORR)为33.3%;纯合突变型(TT)PR2例,SD6例,PD4例,ORR为16.7%;杂合突变型(CT)SD13例,PD9例,ORR为0。CC型患者化疗ORR显著高于TT型和CT型者(P=0.001)。CC型与TT型/CT型患者的肿瘤进展时间(TTP)分别为6.2个月和4.7个月,差异有统计学意义(P=0.022)。结论:MTHFR基因C677T CC型患者的TTP显著长于TT型患者和CT型患者。野生型(CC)NSCLC患者可能是使用培美曲塞联合顺铂化疗的有效人群。
Objective: To explore the relationship between the methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and the efficacy of pemetrexed combined with cisplatin in patients with non-small cell lung cancer (NSCLC). Methods: Totally 88 patients (NSCLC) were enrolled in the study. Peripheral blood was collected before chemotherapy. The gene polymorphism of MTHFR677C / T was detected by Taqman MGB probe real-time PCR. The relationship between MTHFR677C / . Results: The distribution of MTHFR gene C677T wild type (CC) was 61.4% (54/88) in all patients, TT was 13.6% (12/88) and heterozygous mutation (CT) was 25.0 % (22/88). The curative effect of the pemetrexed / cisplatin chemotherapy regimen was: 18 cases of wild type (CC) PR, 18 cases of SD and 17 cases of PD with the total effective rate (ORR) of 33.3%; 2 cases of homozygous mutant (TT) PD4 cases, ORR was 16.7%; heterozygous mutant (CT) SD13 cases, PD9 cases, ORR was 0. The ORR of CC patients was significantly higher than that of TT and CT patients (P = 0.001). The tumor progression time (TTP) in patients with CC type and TT type / CT type were 6.2 months and 4.7 months, respectively, with significant difference (P = 0.022). Conclusion: The TTP of C677T CC patients with MTHFR gene is significantly longer than that of TT patients and CT patients. Patients with wild-type (CC) NSCLC may be an effective population using pemetrexed plus cisplatin chemotherapy.