BIM基因多态性对NSCLC行铂类药物化疗的观察

Effect of BIM gene polymorphism on platinu based chemotherapy for NSCLC patients

目的探讨BIM基因多态性对晚期非小细胞肺癌(Non-small cell lung cancer,NSCLC)行铂类药物化疗预后的影响。方法选取晚期NSCLC患者84例,均采用铂类药物开展化疗,对其BIM基因多态性采用多聚酶链反应方法进行检测,探讨BIM多态性与NSCLC患行铂类药物化疗预后的相关性。结果 (1) 84例中,共检测出70例BIM基因无多态性患者(即野生型)和14例BIM有多态性患者(12例混合型和2例缺失型)。(2)相较于BIM基因混合、缺失型患者,野生型患者在化疗后的CA125、CEA指标进一步降低(P <0. 05),且其客观缓解率明显提高(47. 14%vs 14. 29%,P <0. 05),但疾病控制率无明显差异(80. 00%vs71. 43%,P> 0. 05)。(3)相较于BIM基因混合、缺失型患者,BIM基因野生型患者的中位生存期明显延长(P<0. 05),且1年、2年、3年生存率亦明显提高(P <0. 05),化疗后的KPS评分亦显著高于前者(P <0. 05)。(4) BIM基因野生型患者的不良反应发生率为24. 29%显著低于BIM基因混合、缺失型患者的42. 86%,差异有统计学意义(P <0. 05)。(5)通过Cox比例风险回归模型分析,BIM基因多态性对晚期NSCLC患者化疗后的中位无进展生存期具有显著影响(P=0. 005)。结论 BIM基因多态性可对晚期非小细胞肺癌行铂类药物化疗预后产生明显影响,对BIM基因多态性开展检测,可有效评估患者的疾病预后。

Objective To investigate the effect of BIM gene polymorphism on the prognosis of non-small cell lung cancer(NSCLC)after platinum based chemotherapy.Methods 84 patients with advanced NSCLC were treated with platinum drugs,and the polymorphism of BIM gene was detected by polymerase chain reaction.The correlation between BIM polymorphism and chemotherapy prognosis of NSCLC patients with platinum drugs was investigated.Results (1)In 84 cases,70 cases of BIM gene free polymorphism(wild type)and 14 BIM polymorphic patients(12 mixed and 2 missing)were detected.(2)Compared with the patients with mixed or deleted BIM gene,the indexes of CA125 and CEA in wild type patients were further decreased(P<0.05),and the objective remission rate was significantly increased(47.14% vs 14.29%,P<0.05),but the disease control rate was not significantly different(80.00% vs 71.43%,P>0.05).(3)Compared with the patients with mixed or deleted BIM gene,the median survival time of wild-type BIM gene patients was significantly longer(P<0.05),and the 1-year,2-year and 3-year survival rates were significantly higher(P<0.05),and the KPS score after chemotherapy was significantly higher(P<0.05).(4)The incidence of adverse reactions in wild-type patients with BIM gene was 24.29%,which was significantly lower than 42.86% in mixed and deleted patients with BIM gene(P<0.05).(5)By Cox proportional hazard regression analysis,BIM gene polymorphism had a significant effect on the median progression-free survival(P=0.005)of patients with advanced NSCLC after chemotherapy.Conclusion BIM gene polymorphism can significantly affect the prognosis of advanced non-small cell lung cancer with platinum chemotherapy,and the detection of BIM gene polymorphism can effectively evaluate the prognosis of the patients.