论文部分内容阅读
目的检测转移性结直肠癌患者外周血血管内皮生长因子(vascular endothelial growth factor,VEGF)启动子区域单核苷酸多态性(single nucleotide polymorphism,SNP),探讨VEGF的SNP与患者预后的关系。方法收集2012年1月至2015年12月在本院治疗的60例转移性结直肠癌患者接受化疗前的外周血样本,所有患者均接受标准方案化疗,其中20例加用了贝伐珠单抗。应用质谱分析法,进行3个VEGF启动子区域基因多态性的检测,包括-2578C>A、-460T>C和-1455T>C。结果60例转移性结直肠癌患者,所有患者中位总体生存期(OS)为16.0月;联合贝伐株单抗组的中位OS为34.0月优于单用化疗组的中位OS为12.7月(P=0.004);VEGF各SNP变异率与美国国家生物技术信息中心数据库数据相似,-2578C>A和-460C>T变异具有较高一致性,60例患者中59例在纯合、杂合变异及纯合变异3个方面完全一致(P=0.76);-2578C>A和-460C>T不同变异的总生存期差异无统计学意义(P>0.05),在联合贝伐珠单抗组患者中,-2578C>A和-460T>C的纯合子变异者仍然存活,杂合子变异者3年生存率仅28.6%。结论外周血VEGF启动子部分位点的SNP状态与转移性结直肠癌患者化疗的长期疗效可能相关。
Objective To detect the single nucleotide polymorphism (SNP) in the promoter region of vascular endothelial growth factor (VEGF) in patients with metastatic colorectal cancer and to explore the relationship between the SNP of VEGF and the prognosis of patients. Methods Peripheral blood samples from 60 patients with metastatic colorectal cancer treated in our hospital from January 2012 to December 2015 were collected before chemotherapy. All patients received standard chemotherapy, of which 20 were treated with bevacizumab anti. Mass spectrometry was used to detect the polymorphisms of three VEGF promoter regions, including -2578C> A, -460T> C and -1455T> C. Results The median overall survival (OS) of 60 patients with metastatic colorectal cancer was 16.0 months. The median OS of the combined bevacizumab group was 34.0 months, which was better than that of the chemotherapy alone group. The median OS was 12.7 months (P = 0.004). The mutation rates of VEGF SNPs were similar to those of the database of the National Center for Biotechnology Information of the United States. The variation of -2578C> A and -460C> T was highly consistent with that of 59 cases of homozygous and heterozygous (P = 0.76). There was no significant difference in the overall survival between 2578C> A and -460C> T (P> 0.05). In combination with bevacizumab Among the patients, homozygous mutants with -2578C> A and -460T> C still survived, and heterozygous mutants had a 3-year survival rate of only 28.6%. Conclusion The SNP status of VEGF promoter in peripheral blood may be related to the long-term efficacy of chemotherapy in patients with metastatic colorectal cancer.