多基因联合检测在晚期胃癌个体化化疗中的临床应用

Clinical application of individualized chemotherapy guided by combined multigene detection for patients with advanced gastric cancer

目的观察通过检测晚期胃癌患者血清中的相关肿瘤药物敏感基因选择个体化化疗方案的临床疗效。方法将52例晚期胃癌患者分为两组:试验组27例,化疗前先检测血清中的切除修复交叉互补基因1、人微管蛋白β3和DNA拓扑异构酶Ⅱa基因mRNA表达水平并指导个体化化疗;对照组25例,采用常规化疗。比较两组近期疗效、不良反应和远期生存率。结果试验组和对照组的有效率(55.6%vs.52.0%)和临床获益率(85.2%vs.80.0%)差异均无统计学意义(P>0.05)。试验组的恶心、呕吐和骨髓抑制等发生率低于对照组(P<0.05)。试验组和对照组中位生存期和无进展生存期相仿(15.4个月vs.12.6个月和9.1个月vs.7.8个月)(P>0.05)。结论肿瘤药物敏感基因检测指导下的个体化化疗与传统三药化疗疗效相当,但是毒性反应明显减低。

Objective To observe the efficacy of selective individualized chemotherapy regimen guided by detecting serum tumor drug-sensitive genes in the patients with advanced gastric cancer.Methods Fifty-two patients with advanced gastric cancer were treated with selective individualized chemotherapy regimen guided by detecting serum tumor drug-sensitive genes(group A,27 cases)or conventional DCF chemotherapy regimen(group B,25 cases).Branched-DNA liquid chip quantitative analysis was used in group A to detect the mRNA expression levels of ERCC1,TUBB3 and TOPOⅡa.The short-term efficiency,toxicity and long-term survival were compared between two groups.Results The overall response rates and disease control rates in groups of A and B were similar(55.6% vs.52.0%)(P>0.05).So did the clinical benefit rates(85.2% vs.80.0%).The incidences of adverse effects,nausea,vomiting and myelosuppression were less in group A than those in group B(P<0.05).There were no significant differences in the median of overall survival(15.4 months vs.12.6 months)and the progression-free survival(9.1 months vs.7.8 months)in groups of A and B(P>0.05).Conclusion Compared to conventional DCF chemotherapy regimen for the patients with advanced gastric cancer,the selective individualized chemotherapy regimen guided by detecting serum tumor drug-sensitive genes has the same clinical efficacy but is with less adverse responses.