动脉栓塞化疗宫颈癌患者近期疗效差异的HSPA1A基因多态性及影响因素分析

Analysis of HSPA1A gene polymorphism and influencing factors of differences in short-term efficacy of cervical cancer patients with arterial embolization chemotherapy

目的探讨动脉栓塞化疗宫颈癌患者近期疗效差异的HSPA1A基因多态性及影响因素。方法随机选取187例宫颈癌患者(Ⅰb~Ⅲb期)作为宫颈癌组,再根据化疗效果分为疗效好组(n=142)和疗效差组(n=45);随机选取同时期体检正常的女性106例作为对照组。采用TaqMan探针基因分型法研究HSPA1A基因SNP位点rs1008438(G>T)的等位基因、基因型的分布频率;采用荧光定量PCR法检测XIAP和Smac基因的相对表达量。结果rs1008438位点等位基因G和T在疗效好组和对照组、疗效好组和疗效差组中的分布频率比较,差异具有统计学意义(P<0.05)。动脉栓塞化疗后,疗效好组XIAP基因的相对表达量降低,凋亡细胞数增加(P<0.05)。Spearman相关性分析显示,患者动脉栓塞化疗前的XIAP基因表达量、凋亡细胞数、宫颈病灶大小评分、宫旁受侵质地评分及总分与化疗后疗效差异相关(P<0.05)。结论针对宫颈癌化疗疗效差的患者,要综合考虑宫颈局部病灶和宫旁受侵组织的情况,进一步改进治疗方案。

Objective To investigate the HSPA1A gene polymorphism and influencing factors of differences in short-term efficacy of cervical cancer patients with arterial embolization chemotherapy.Methods A total of 187 patients with cervical cancer(Ⅰb-Ⅲb)were randomly selected as cervical cancer group,and then divided into good efficacy group(n=142)and poor efficacy group(n=45)according to the chemotherapy effect;a total of 106 women with normal physical examination at the same time were randomly selected as control group.TaqMan probe genotyping method was used to study the distribution frequency of alleles and genotypes at SNP locus rs1008438(G>T)of HSPA1A gene;fluorescence quantitative PCR method was used to detect the relative expression of XIAP and Smac genes.Results The distribution frequencies of alleles G and T at the rs1008438 locus between the good efficacy group and the control group,the good efficacy group and the poor efficacy group were compared,and the differences were statistically significant(P<0.05).After arterial chemoembolization,the relative expression of XIAP gene in the good efficacy group decreased,and the number of apoptotic cells increased(P<0.05).Spearman correlation analysis showed that XIAP gene expression,number of apoptotic cells,cervical lesion size score,parauterine invasion score and total score before arterial embolization chemotherapy were related to the difference in efficacy after chemotherapy(P<0.05).Conclusion For patients with poor efficacy of chemotherapy for cervical cancer,it is necessary to comprehensively consider the local cervical lesions and the invaded tissues around the uterus to further improve the treatment plan.