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目的:定量评价胃癌患者X线修复交叉互补基因1(X-ray repair cross-complementing group 1,XRCC1)Arg399Gln多态性与铂类药物化疗敏感性的关系。方法:计算机检索PubMed、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库和万方数据库,收集胃癌患者XRCC1Arg399Gln多态性与铂类药物化疗敏感性的相关研究。化疗敏感评价指标为临床有效(完全缓解+部分缓解)率为化疗敏感评价指标。应用RevMan 5.2和STATA 12.0软件进行统计学分析,计算合并比值比(odds ratio,OR)及95%可信区间(confidence interval,CI)。结果:本研究共纳入8篇文献(1 068例)。Meta分析结果显示,各基因型之间(GA vs GG:OR=0.71,95%CI为0.50~1.01;AA vs GG:OR=0.76,95%CI为0.43~1.36;GA+GG vs AA:OR=1.08,95%CI为0.63~1.86;GA+AA vs GG:OR=0.67,95%CI为0.43~1.05)以及亚洲人群亚组中(GA+AA vs GG:OR=0.64,95%CI为0.35~1.16)XRCC1Arg399Gln多态性与化疗敏感性差异无统计学意义。按检测方法进行敏感性分析后,结果显示GA+AA vs GG有统计学意义(OR=0.58,95%CI为0.40~0.86);而在亚洲人群亚组中(GA+AA vs GG:OR=0.53,95%CI为0.37~0.75)的差异更加显著。结论:XRCC1Arg399Gln基因多态性可能与胃癌铂类药物化疗耐药相关。
OBJECTIVE: To quantitatively evaluate the relationship between the Arg399Gln polymorphism of XRCC1 and chemosensitivity of platinum-based chemotherapy in patients with gastric cancer. Methods: PubMed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database and Wanfang Database were searched. The relationship between XRCC1Arg399Gln polymorphism and chemosensitivity to platinum-based chemotherapy in gastric cancer was collected. Chemosensitivity evaluation index for the clinical effective (complete remission + partial response) rate of chemotherapy-sensitive evaluation index. Statistical analysis was performed using RevMan 5.2 and STATA 12.0 software to calculate the odds ratio (OR) and 95% confidence interval (CI). Results: Eight literatures (1,068 cases) were included in this study. Meta-analysis showed that there was significant difference between the genotypes (GA vs GG: OR = 0.71, 95% CI 0.50-1.01; AA vs GG: OR = 0.76, 95% CI 0.43 to 1.36; = 1.08, 95% CI 0.63-1.86; GA + AA vs GG: OR = 0.67, 95% CI 0.43-1.05) and in the Asian subgroup (GA + AA vs GG: OR = 0.64, 95% CI 0.35 ~ 1.16) XRCC1Arg399Gln polymorphism and chemosensitivity difference was not statistically significant. According to the sensitivity test, the results showed that GA + AA vs GG was statistically significant (OR = 0.58, 95% CI: 0.40-0.86); while in the Asian subgroup (GA + AA vs GG: OR = 0.53, 95% CI 0.37 to 0.75). Conclusion: The polymorphism of XRCC1Arg399Gln gene may be related to chemoresistance of platinum-based drug in gastric cancer.