MGMT基因甲基化检测在神经胶质瘤治疗中的应用

Value of MGMT Gene Methylation Detection in Treatment of Glioma

神经胶质瘤是一种常见的、复杂的恶性肿瘤,现有的治疗方法仍不能明显提高患者的生存期。近年来,越来越多的研究表明MGMT启动子甲基化状态与神经胶质瘤诊断、治疗和预后密切相关。编码修复O6-甲基鸟嘌呤的MGMT可以帮助肿瘤细胞逃避烷化剂的细胞毒作用,但MGMT启动子常会因为发生甲基化降低基因的表达,最终阻碍DNA的修复。研究已证实MGMT基因甲基化是一种可靠的胶质瘤预测标志物,且MGMT基因甲基化的胶质瘤患者对化、放疗更敏感,生存期更长。根据患者的MGMT基因甲基化状态,制定及实施不同的治疗方案,实现个体化治疗或许可以提高化、放疗疗效和改善预后。因此,本文对MGMT基因甲基化检测在神经胶质瘤治疗中的作用以及目前常用的MGMT基因启动子甲基化检测方法的研究进展进行了综述。

Glioma is a common and complex malignant tumor,the currently our existing treatments can not significantly improve the patient＇s survival. In recent years,more and more studies have shown that MGMT promoter methylation status is closely related to the diagnosis,treatment and prognosis of glioma. Alkylator resistance of glioma cells is mainly mediated by the DNA repair enzyme O6-methylguanine-DNA methyltransferase（MGMT）. However,frequent methylated MGMT promoters reduce the expression of MGMT gene,eventually hinder DNA repair. Research has confirmed that the MGMT gene methylation is a strong prognostic biomarker in patients with glioblastoma. Notably,patient with MGMT gene methylation is more sensitive to the chemo- or radio- therapy,whose lifetime is longer. According to MGMT gene methylation status,different treatments regimes can be chosen,and the individualized treatments may improve the curative effect of chemo- or radio- therapy and prognosis. This article reviews the current progress on the prognostic and predictive relevance of MGMT gene methylation in treatment of glioma,and discusses the commonly used DNA methylation-specific assays.