卵巢上皮性癌患者BRCA1/2和KRAS基因突变与预后的相关性研究

Correlation Study on BRCA1/2 and KRAS Gene Mutations and Prognosis in Patients with Epithelial Ovarian Cancer

目的探讨卵巢上皮性癌患者BRCA1/2和KRAS基因突变与预后的关系。方法运用基因测序分析2007年1月—2009年12月收治的术后采用顺铂、紫杉醇化疗的卵巢上皮性癌95例的BRCA1/2和KRAS基因突变情况,并根据检测结果分为突变组和未突变组,随访5年生存情况;采用Kaplan-Meier法分析BRCA1/2和KRAS基因突变状态及其与术后化疗预后的关系,Cox比例风险回归模型分析卵巢上皮性癌患者预后的影响因素。结果 BRCA1/2基因突变率为35.8%,KRAS基因突变率为7.4%。BRCA1/2基因突变组5年生存率高于未突变组(P<0.05);KRAS基因突变组和未突变组的5年生存率比较差异无统计学意义(P>0.05)。肿瘤分级、对化疗敏感与否、BRCA1/2基因突变与否以及组织学状况为预后影响因素,BRCA1/2基因突变的患者其死亡风险低于未突变者(P<0.05)。结论 BRCA1/2基因突变患者对顺铂、紫杉醇化疗敏感性好,患者预后生存时间相对较长,该基因可作为指导卵巢癌患者临床个性化化疗的生物标记物。

Objective To discuss correlation between BRCA1/2 and KRAS gene mutation and prognosis in patients with epithelial ovarian cancer. Methods The mutation conditions of BRCA1/2 and KRAS genes in 95 patients with epithelial ovarian cancer treated by Cisplatin and Paclitaxel during January 2007 and December 2009 were analyzed by gene sequencing, and the patients were divided into mutant group and non-mutated group according to detection re- suits, and survival conditions were observed during 5-year follow-up. Kaplan-Meier method was used to analyze correla- tion between mutation conditions of BRCA1/2 and KRAS genes and prognosis by .postoperative chemotherapy. Influencing factors of prognosis in patients with epithelial ovarian cancer were analyzed by Cox proportional hazards regression models. Results BRCA1/2 gene mutation rate was 35.8% , and KRAS gene mutation rate was 7.4%. The 5-year survival rate in BRCA1/2 gene mutant group was significantly higher than that in non-mutated group （P 〈 0. 05 ）. There was no significant difference in 5-year survival rate between KRAS gene mutant group and non-mutation group （ P 〉 0.05 ）. Tumor classification, sensitivity for chemotherapy, whether or not BRCA1/2 gend mutation and histological status were influen-cing factors of prognosis, and death risk in patients with BRCA1/2 gene mutation was lower than that in patients without BRCA1/2 gene mutation. Conclusion Patients with BRCA1/2 gene mutations have good sensitivity for Cisplatin and Paclitaxel chemotherapy, and the patients can get a relatively long survival time, and therefore the gene can be used as a biomarker to guide clinical individuation chemotherapy in patients with ovarian cancer.