RRM1基因多态性与吉西他滨联合顺铂治疗非小细胞肺癌的关系

The relationship between RRM1 gene polymorphism and Gemcitabine combining cisplatin chemotherapy for treating nonsmall-cell lung cancer

目的探讨RRM1基因多态性与非小细胞肺癌患者吉西他滨联合顺铂化疗效果及临床预后的关系。方法回顾性分析2015年6月-2016年6月在本院收治的非小细胞肺癌患者80例,所有患者均采用GP方案化疗,在化疗前均抽取外周血检测患者RRM1多态性,记录患者化疗效果,探讨RRM1基因多态性与患者化疗敏感性的关系,并采用Logistic回顾模型探讨RRM1基因多态性与非小细胞肺癌患者临床预后的关系。结果 80例患者出现的不良反应发病率为白细胞减少51.9%、胃肠道症状(恶性呕吐)48.1%、肝功能异常18.5%、外周神经毒性51.9%,各不良反应以Ⅰ度为主。80例患者中CR 10例、PR 13例、SD 34例、PD 23例,RRM1*27(A/A)、RRM1*524(T/T)缓解率高于其他基因型患者,差异有统计学意义(P<0.05)。肿瘤N分期、RRM1*27(C/C)、RRM1*524(C/C)是非小细胞肺癌患者死亡、转移或复发的独立危险因素(P<0.05)。结论 RRM1基因型与患者化疗效果及预后明显相关,值得临床关注。

Objective To investigate the relationship between the RRM1 gene polymorphism and the effect and prognosis of Gemcitabine combining cisplatin chemotherapy in patients with non- small cell lung cancer. Methods Retrospective analysis was performed on 80 cases of patients with nonsmall- cell lung cancer from our hospital during December 2015- June 2016; all patients were treated with GP regimen; peripheral blood were extracted from all patients for the detection of RRM1 polymorphism,chemotherapy efficiency was recorded,and the relationship between RRM1 polymorphism and chemotherapeutic sensitiveness was discussed. Logistic regression model was used to investigate the relationship between RRM1 gene polymorphism and clinical prognosis in patients with non- small cell lung cancer. Results The adverse reactions in 80 cases were leukopenia decreasing 51. 9%,gastrointestinal symptoms [（ nausea and vomiting） 48. 1% ],abnormal liver function（ 18. 5%）,peripheral neurotoxicity（ 51. 9%）,with all adverse reactions in degreeⅠ. There were 10 cases of CR,13 cases of PR,34 cases of SD,23 cases of PD,and the remission rates of RRM1 27（ A / A）,RRM1（ 524 T / T） were significantly higher than that of other genotypes in patients,with the differences statistically significant（ P〈0. 05）. Tumor in N state,RRM1 27（ C / C）,RRM1 524（ C/C） were independent risk factors to deaths,metastasis or recurrence in patients with non- small cell lung cancer. Conclusion RRM1 genotype is significantly associated with chemotherapy and prognosis,which is worthy of clinical attention.