多基因联合检测对晚期胃癌个体化化疗效果的研究

目的探讨核苷酸切除修复交叉互补基因1（ERCC1）和β微管蛋白Ⅲ基因（TUBB3）联合检测对晚期胃癌个体化化疗效果的影响。方法收集2013年6月至2015年6月晚期胃癌患者50例，将其随机分为观察组和对照组，每组各25例。观察组根据ERCC1、TUBB3基因mRNA表达水平检测结果选择不同的化疗方案；对照组不进行基因检测，采用DCF方案化疗；21d为1个周期。两组均化疗≥4个周期。观察比较两组的化疗效果及毒副反应。结果观察组有效率为68．00％，高于对照组的56．00％，但两组差异无统计学意义（P〉0．05）。两组均未出现与化疗相关的死亡事件，化疗的主要毒副反应为骨髓抑制、消化道反应、黏膜炎、肝肾功能损害、心脏毒性等方面。其中两组的骨髓抑制、消化道反应、黏膜炎发生率差异有统计学意义（P〈0．05）。结论ERCC1和TUBB3联合检测并基于其的化疗方案对晚期胃癌患者具有安全性高、毒副反应少的优点，可提高化疗效果。

Objective To investigate the influnce of excision repair cross-complementing gene 1 （ ERCCI ） and β -Tubulin-Ⅲ （ TUBB3 ） combined detection of individual chemotherapy for advanced gastric cancer. Methods 50 cases of patients with advanced gastric cancer in our hospital from June 2013 to June 2015 were selected, and were randomly divided into observation group and control group, 25 cases in each group. Different chemotherapy regimens were chosen in observation group based on ERCC1, TUBB3 gene mRNA expression test Results. DCF regimen was given to control group without genetic testing. 21 days was a treatment course, both groups were at least four cycles of chemotherapy. The efficacy and toxicity of chemotherapy was compared between the two groups. Results The effective rate of observation group was 68.00%, higher than 56.00% of control group, but the difference was significant （ P〉0.05 ） . There were no death associated with chemotherapy ouucred in the two groups, main side effects of chemotherapy were bone marrow suppression, gastrointestinal reactions, mucositis, liver and kidney dysfunction, cardiac toxicity. The incidence of bone marrow suppression, gastrointestinal reactions, mucositis between the two groups was significant （P〈0.05） . Conclusion ERCC1 and TUBB3 multiple genes combined detection of individual chemotherapy for advanced gastric cancer has the advantages of high security, less toxicity, and can enhance the effect of chemotherapy.