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目的检测华南地区伊立替康联合方案治疗晚期结直肠癌患者UGT1A*28基因的多态性,观察伊立替康治疗晚期结直肠癌的疗效和不良反应,用于指导临床用药。方法 收集华南地区晚期结直肠癌患者共214例,给予伊立替康联合5-FU/LV方案化疗,并进行UGT1A1*28基因多态性测定,观察患者疗效和不良反应。结果 167例(80.29%)患者为TA6/6纯合野生基因型,40例(19.23%)患者为TA6/7杂合突变基因型,1例(0.48%)患者为TA7/7纯合突变基因型。TA6/6野生基因型和突变基因型患者的客观有效率(ORR)分别为31.20%和20.0%(P=0.191),疾病控制率(DCR)分别为90.78%和74.29%(P=0.008)。TA6/7及TA7/7突变基因型患者采用伊立替康治疗时严重延迟性腹泻和粒细胞减少症发生率分别为9.76%、9.76%,高于TA6/6野生基因型的5.39%和3.59%。结论 UGT1A1*28不同基因型对伊立替康治疗晚期结直肠癌的疗效和不良反应均有差异。
Objective To investigate the polymorphism of UGT1A * 28 gene in patients with advanced colorectal cancer treated with irinotecan in South China and to observe the efficacy and adverse reactions of irinotecan in the treatment of advanced colorectal cancer. METHODS: A total of 214 patients with advanced colorectal cancer in southern China were enrolled and given irinotecan combined with 5-FU / LV chemotherapy. The UGT1A1 * 28 gene polymorphism was measured to observe the efficacy and adverse reactions of the patients. Results TA6 / 6 homozygous wild type was found in 167 patients (80.29%), TA6 / 7 heterozygous mutation in 40 patients (19.23%) and TA7 / 7 homozygous mutation in 1 patient (0.48%) type. The objective response rates (ORR) of TA6 / 6 genotypes and mutant genotypes were 31.20% and 20.0% (P = 0.191), and the disease control rates (DCR) were 90.78% and 74.29% (P = 0.008). The incidences of severe delayed diarrhea and neutropenia in patients with TA6 / 7 and TA7 / 7 mutation genotypes were 9.76% and 9.76% when treated with irinotecan, respectively, which were higher than 5.39% and 3.59% of TA6 / 6 wild genotypes, respectively . Conclusion The efficacy and adverse reactions of different genotypes of UGT1A1 * 28 for irinotecan in patients with advanced colorectal cancer are different.