EGFR基因多态性对局部晚期宫颈癌术后化疗患者临床疗效的影响

The influence of single nucleotide polymorphisms of EGFR on the clinical efficacy of postoperative chemotherapy in locally advanced cervical cancer

目的探讨局部晚期宫颈癌患者表皮生长因子受体(EGFR)基因多态性对术后化疗效果的影响。方法选取局部晚期宫颈癌患者132例,所有患者手术治疗后均接受化疗。应用聚合酶链反应-连接酶反应检测EGFR基因型,根据EGFR基因型不同,将患者分为G/G基因型组(n=28)、G/A基因型组(n=70)、A/A基因型组(n=34)。比较3组患者化疗后的复发情况、病死情况及化疗期间不良反应发生情况,并对局部晚期宫颈癌患者化疗后复发的影响因素进行分析。结果 3组患者的化疗后1年复发率比较,差异无统计学意义(P﹥0.05);3组患者的化疗后2年复发率比较,差异有统计学意义(P﹤0.05),其中G/A基因型组和A/A基因型组患者的化疗后2年复发率均低于G/G基因型组(P﹤0.05)。3组患者的化疗后1年和化疗后2年病死率比较,差异均无统计学意义(P﹥0.05);化疗期间,3组患者消化道症状、神经毒性、中性粒细胞缺乏、血小板减少、转氨酶升高的发生率比较,差异均无统计学意义(P﹥0.05)。多因素Logistic回归分析显示,EGFR基因型为G/G型是局部晚期宫颈癌患者化疗后2年复发的独立危险因素(P=0.02)。结论 EGFR基因型为G/G型与局部进展期宫颈癌患者化疗后复发有关。

Objective To investigate the influence of single nucleotide polymorphisms of epidermal growth factor receptor （EGFR） on the clinical efficacy of postoperative chemotherapy in locally advanced cervical cancer. Method One hundred and thirty-two cases of locally advanced cervical cancer were selected, and all patients received chemotherapy after the operation. Polymerase chain reaction-ligase detection reaction was used to detect the gene type of EGFR. Accord- ing to different EGFR genotypes, patients were divided into G/G genotype group （n=28）, G/A genotype group （n=70） and A/A genotype group （n=34）. The incidence of postchemotherapy recurrence, death and adverse reactions during chemo- therapy in the three groups were compared, and the influencing factors of postchemotherapy recurrence in locally advanced cervical cancer patients were analyzed. Result There was not significant difference among three groups in 1- year recurrence rate after chemotherapy （P〉0.05）, and the differences among the daree groups in 2-year recurrence rate af- ter chemotherapy were significant （P〈0.05）. The 2-year recurrence rates after chemotherapy of patients with G/A and A/A genotype were both significantly lower thma that of patients with G/G genotype （P〈0.05）. There was no statistically significant differences in 1-year or 2-year mortality after chemotherapy among daree groups （P〉0.05）. During the chemothera- py, there was no statistically significant differences in the incidences of digestive symptoms, neurotoxicity, neutropenia, darombocytopenia and transaminase elevation among the three groups （P〉0.05）. Multivariate Logistic regression analysis showed that G/G genotype of EGFR was an independent risk factor for recurrence in locally advanced cervical cancer after 2 years of chemotherapy （P=0.02）. Conclusion G/G genotype of EGFR is associated with postchemotherapy recurrence in locally advanced cervical cancer patients.