ERCC1 mRNA和X线修复交叉互补组1基因多态性联合检测在局部晚期鼻咽癌患者放化疗中的应用价值

Application of combined detection of ERCC1 mRNA and XRCC1 polymorphism in chemoradiotherapy of locally advanced nasopharyngeal carcinoma

目的 探讨核苷酸切除修复交叉互补组1(ERCC1)m RNA和X线修复交叉互补组1(XRCC1)基因多态性联合检测在局部晚期鼻咽癌患者放化疗中的应用价值。方法 选取2020年1月至2021年1月在江西省上饶市人民医院接受放化疗的41例局部晚期鼻咽癌患者,采用定量反转录聚合酶链反应检测外周血中ERCC1 mRNA的表达水平,采用限制性片段长度多态性聚合酶链反应检测XRCC1基因型(Arg194Trp、Arg280His、Arg399Gln),探讨ERCC1 mRNA和XRCC1多态性与局部晚期鼻咽癌患者放化疗效果、肿瘤复发及药物不良反应(ADR)的关系,并采用logistic回归分析局部晚期鼻咽癌患者ADR的影响因素。结果 完全缓解和部分缓解患者的ERCC1 mRNA及XRCC1多态性与疾病稳定和疾病进展患者比较差异无统计学意义(P>0.05)。肿瘤复发患者的ERCC1 mRNA及XRCC1多态性与非复发患者比较差异无统计学意义(P>0.05)。ADR患者XRCC1 Arg194Trp位点携带AG基因型、ERCC1 mRNA高表达的频率均高于非ADR患者,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,XRCC1 Arg194Trp AG基因型(OR=1.876)、ERCC1mRNA高表达(OR=1.109)是局部晚期鼻咽癌患者放化疗期间发生ADR的影响因素(P<0.05)。结论 与单一检测相比,ERCC1 mRNA和XRCC1多态性联合检测预测局部晚期鼻咽癌患者放化疗期间ADR的价值更高,值得临床应用。

Objective To investigate the application of combined detection of ERCC1 mRNA and XRCC1 polymorphism in radiotherapy and chemotherapy of locally advanced nasopharyngeal carcinoma.Method From January 2020 to January 2021,41 patients with locally advanced nasopharyngeal carcinoma in our hospital were studied.The expression level of ERCC1 mRNA in peripheral blood was detected by qRT-PCR.The XRCC1 genotypes(Arg194Trp,Arg280His,Arg399Gln)were detected by restriction fragment length polymorphism polymerase chain reaction(PCR-RFLP).Logistic regression was used to analyze the relationship between ERCC1 mRNA and XRCC1 polymorphisms and adverse drug reactions.Result There was no significant difference in ERCC1 mRNA and XRCC1 polymorphism between CR+PR group and SD+PD group(P>0.05).There was no significant difference in ERCC1 mRNA and XRCC1 polymorphism between tumor recurrence group and non-tumor recurrence group(P>0.05).The AG genotype of XRCC1 Arg194 Trp locus,high expression of ERCC1 mRNA and AG+high expression frequency in ADR group were higher than those in non-ADR group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that XRCC1 Arg194Trp AG genotype(OR=1.876),high expression of ERCC1 mRNA(OR=1.109),and AG+high expression(OR=4.235)were the influencing factors of ADR during radiotherapy and chemotherapy for locally advanced nasopharyngeal carcinoma(P<0.05).Conclusion Compared with single detection,the combined detection of XRCC1 Arg194 Trp AG+ERCC1 mRNA high expression has a greater value in predicting adverse drug reactions during radiotherapy and chemotherapy for locally advanced nasopharyngeal carcinoma,which is worthy of clinical promotion.