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目的研究亚甲基四氢叶酸还原酶基因(MTHFR)C677T多态性与大肠癌术后患者接受卡培他滨联合奥沙利铂(XELOX)方案辅助化疗疗效的关系。方法对行大肠癌根治术后接受XELOX方案化疗的62例患者,采用竞争性等位基因特异性聚合酶链式反应(KASP)法检测MTHFR C677T基因多态性并分析其与预后及不良反应相关性。结果 62例结直肠癌患者的MTHFR C677T位点存在3种等位基因型,其基因频率分别为:C/C 46.8%,C/T 40.3%,T/T 12.9%。C/T及T/T型患者无复发生存时间较C/C型延长(Log-rank=4.778,P<0,05)。其中C/C型患者复发率为58.6%,显著高于T/T及C/T基因型患者的33.3%(χ~2=3.985,P<0.05)。TNM分期(HR=5.326,P<0,05)及MTHFR C677T基因多态性(HR=0.284,P<0.05)是术后辅助化疗预后的影响因素。化疗毒副反应中以胃肠道反应和骨髓抑制为主,但不同基因型之间差异并不具有统计学意义(P>0.05)。结论 MTHFR C677T基因多态性与XELOX方案辅助化疗预后相关。TNM分期(Ⅳ期)术后辅助化疗预后差。MTHFR C677T基因多态性与化疗引起的毒副反应无关。
Objective To investigate the relationship between methylenetetrahydrofolate reductase gene (MTHFR) C677T polymorphism and the efficacy of adjuvant chemotherapy with capecitabine plus oxaliplatin in patients with colorectal cancer after surgery. Methods Sixty-two patients undergoing radical XELOX chemotherapy after radical operation of colorectal cancer were analyzed by competitive allele-specific polymerase chain reaction (KASP) to detect the polymorphism of MTHFR C677T gene and its relationship with prognosis and adverse reactions Sex. Results There were three alleles of MTHFR C677T in 62 patients with colorectal cancer. The frequency of CTH gene was 46.8% in C / C, 40.3% in C / T and 12.9% in T / T. The recurrence-free survival was longer in C / T and T / T patients than in C / C patients (Log-rank = 4.778, P <0.05). The recurrence rate was 58.6% in C / C patients, which was significantly higher than 33.3% in patients with T / T and C / T genotypes (χ ~ 2 = 3.985, P <0.05). TNM staging (HR = 5.326, P <0.05) and MTHFR C677T gene polymorphism (HR = 0.284, P <0.05) were the prognostic factors for postoperative adjuvant chemotherapy. The main side effects of chemotherapy were gastrointestinal reaction and bone marrow suppression, but the differences between different genotypes were not statistically significant (P> 0.05). Conclusion MTHFR C677T gene polymorphism is associated with the prognosis of adjuvant chemotherapy with XELOX regimen. Postoperative adjuvant chemotherapy in TNM stage (stage IV) has poor prognosis. MTHFR C677T gene polymorphism and chemotherapy-induced toxicity has nothing to do.