基因检测指导中晚期宫颈癌个体化治疗的临床应用

Clinical application of gene testing in the individualized treatment of advanced cervical cancer

目的探讨 MDR1 (G26677T/A)、 GSTP1 (Ile105Val A/G)、 CDA (A79C)三个基因对中晚期宫颈癌患者临床治疗的指导意义。方法选取46例确诊为中晚期宫颈癌的患者随机分为实验组和对照组,其中实验组23例,对照组23例。通过检测实验组患者外周血中 MDR1 (G26677T/A)、 GSTP1 (Ile105Val A/G)、 CDA (A79C)多态性位点基因型,根据体外检测结果对实验组患者选用敏感度高的药物进行化疗,对照组统一选用紫杉醇联合顺铂化疗,同时两组均进行放射治疗。观察两组患者临床疗效及不良反应。结果实验组患者治疗总有效率为95.65%,对照组为73.91%,差异有统计学意义( P <0.05)。在不良反应方面,两组患者骨髓抑制、胃肠道反应、肝肾功能损害比较,差异均无统计学意义( P >0.05)。同时,实验组中药物敏感组与不敏感组基因型分布比较,差异均有统计学意义( P <0.05)。结论 MDR1 (G26677T/A)、 GSTP1 (Ile105Val A/G)、 CDA (A79C)基因的表达情况与中晚期宫颈癌综合治疗疗效有密切联系,有可能成为指导中晚期宫颈癌选择化疗方案的重要指标。

Objective To explore the guiding significance of MDR1 (G26677T/A), GSTP1 (Ile105Val A/G) and CDA (A79C) genes in the clinical treatment of patients with advanced cervical cancer. Methods 46 patients diagnosed with advanced cervical cancer were randomly divided into experimental group and control group, including 23 patients in the experimental group and 23 patients in the control group. In vitro study on that gene type of MDR1 (G26677T/A), GSTP1 (Ile105Val A/G) and CDA (A79C) polymorphism locus in the peripheral blood of the experimental group patients, the patients with high sensitivity were subject to chemotherapy, and the control group was uniformly selected with paclitaxel with cisplatin, and both group were radiotherapy. The clinical efficacy and adverse reactions of the two groups were observed. Results The total effective rate was 95.65% in the experimental group and 73.91% in the control group, and the difference was statistically significant( P <0.05). There was no significant difference in age, pathological type, clinical stage and blood toxicity between the two groups( P >0.05). At the same time, the genotype distribution between the drug sensitive group and the non-sensitive group in the experimental group was statistically significant( P <0.05). Conclusion MDR1 (G26677T/A), GSTP1 (Ile105Val A/G), CDA (A79C) are closely related with locally advanced cervical cancer treatment, is likely to be important indicators of chemotherapy regimens in locally advanced cervical cancer.