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遗传因素对胰腺癌放疗和化疗生存的影响及修饰作用。

Genetic effects and modifiers of radiotherapy and chemotherapy on survival in pancreatic cancer.

机构信息

Department of Epidemiology and Public Health, School of Public Health and School of Medicine, Yale University, New Haven, CT 06520-8034, USA.

出版信息

Pancreas. 2011 Jul;40(5):657-63. doi: 10.1097/MPA.0b013e31821268d1.

Abstract

OBJECTIVES

Germ-line genetic variation may affect clinical outcomes of cancer patients. We applied a candidate-gene approach to evaluate the effect of putative markers on survival of patients with pancreatic cancer. We also examined gene-radiotherapy and gene-chemotherapy interactions, aiming to explain interindividual differences in treatment outcomes.

METHODS

In total, 211 patients with pancreatic cancer were recruited in a population-based study. Sixty-four candidate genes associated with cancer survival or treatment response were selected from existing publications. Genotype information was obtained from a previous genome-wide association study data set. The main effects of genetic variation and gene-specific treatment interactions on overall survival were examined by proportional hazards regression models.

RESULTS

Fourteen genes showed evidence of association with pancreatic cancer survival. Among these, rs1760217, located at the DPYD gene; rs17091162 at SERPINA3; and rs2231164 at ABCG2 had the lowest P of 10(-4.60), 0.0013, and 0.0023, respectively. We also observed that 2 genes, RRM1 and IQGAP2, had significant interactions with radiotherapy in association with survival, and 2 others, TYMS and MET, showed evidence of interaction with 5-fluorouracil and erlotinib, respectively.

CONCLUSIONS

Our study suggested significant associations between germ-line genetic polymorphisms and overall survival in pancreatic cancer, as well as survival interactions between various genes and radiotherapy and chemotherapy.

摘要

目的

种系遗传变异可能影响癌症患者的临床结局。我们采用候选基因方法,评估候选标志物对胰腺癌患者生存的影响。我们还研究了基因-放疗和基因-化疗相互作用,旨在解释治疗结果的个体间差异。

方法

在一项基于人群的研究中,共招募了 211 名胰腺癌患者。从现有文献中选择了 64 个与癌症生存或治疗反应相关的候选基因。从先前的全基因组关联研究数据集获得基因型信息。通过比例风险回归模型,检验遗传变异的主要效应和基因特异性治疗相互作用对总生存的影响。

结果

有 14 个基因与胰腺癌生存有关。其中,位于 DPYD 基因的 rs1760217、位于 SERPINA3 基因的 rs17091162 和位于 ABCG2 基因的 rs2231164 的 P 值最低,分别为 10(-4.60)、0.0013 和 0.0023。我们还观察到 2 个基因,RRM1 和 IQGAP2,与生存相关的放疗存在显著的相互作用,另外 2 个基因,TYMS 和 MET,分别与 5-氟尿嘧啶和厄洛替尼存在相互作用的证据。

结论

我们的研究表明,种系遗传多态性与胰腺癌的总体生存率之间存在显著关联,以及不同基因与放疗和化疗之间的生存相互作用。

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