外周血CYP3A和GSTM1基因多态性检测对头颈部NHL化疗效果预测意义的分析

Effect of CYP3A and GSTM1 genetic polymorphisms on the treatment of non-hodgkin's lymphoma patients of head and neck

目的:研究CYP3A和GSTM1基因多态性与非霍奇金淋巴瘤(NHL)化疗疗效、毒副作用之间的相关性。方法:收集初治90例头颈部NHL患者和60名正常人及60例非肿瘤住院患者的外周静脉血,提取DNA,以PCR技术检测CYP3A和GSTM1等位基因型,采用CHOP方案治疗患者,比较不同的基因型患者化疗疗效和毒副作用的差别。结果:NHL患者CYP3A突变基因(A-44)频率为66.7%,GSTM1缺失基因频率为58.9%,与正常人两种基因型的分布频率(62.5%和53.3%)差异无统计学意义,χ2值为1.114和0.643,P值均>0.05。W和WM基因型的有效率分别为100.0%(4/4)和92.3%(48/52),均明显高于M基因型患者的29.4%(10/34),χ2值分别为4.930和37.037,P值均<0.05;含GSTM1非缺失基因型(+)的患者(0+Ⅰ期+Ⅱ期)白细胞下降89.2%,缺失基因型(-)患者(0+Ⅰ+Ⅱ期)白细胞下降67.9%,差异有统计学意义,P<0.05。结论:CYP3A和GSTM1基因多态性不增加NHL的患病风险,但能影响NHL患者化疗疗效及毒副作用。

OBJECTIVE： To investigate the relation between CYP3A,GSTM1 genetic polymorphisms and chemo- therapeutic effect,adverse reaction in non-hodgkin＇ s lymphoma （NHL） patients. METHODS： To collect the peripheral blood samples of 90 NHL patients, 60 normal persons and 60 benign patients. Then DNA was extracted, CYP3A and GSTM1 genotypes were analyzed by using the PCR procedure. The NHL patients were treated by using CHOP program. The differences among the different gene types on chemotherapeutic effect and adverse reaction were compared. RESULTS： In NHL patients,the frequencies of CYP3A mutation and GSTM1 null genotype were 66.7% and 58.9% ,respectively. No significant differences were detected between healthy individuals and the patients（62.5% and 53.3 %, respectively, 2 were 1.114 and 0.643, P〉0.05 ）. The effective rate of W and WM genotype were 100.0 % （4/4） and 92.3 % （48/52 ）, all obver- sily higher than the genotype M whose rate was 29.4%（10/34,X2 were 4. 930 and 37. 037,P（0.05）. The frequencies of leukope-nia were 89.2o//00 and 67.9% in GSTM1 non-deletion gene type（＋ ,0＋ Ⅰ ＋ Ⅱ stage） and deletion gene type（＋ ,0＋ Ⅰ ＋ Ⅱ stage） ,there were significant differences in two groups （P（0.05）. CONCLUSIONS： CYP3A and GSTM1 ge- netic polymorphisms may not increase the risk of NHL. But it may influence chemotherapy- eutic effect and adverse reac- tion in NHL patients.