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DNA 修复基因多态性与铂类化疗治疗晚期 NSCLC 患者生存的关系。

Association between polymorphisms of DNA repair genes and survival of advanced NSCLC patients treated with platinum-based chemotherapy.

机构信息

Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University, No 507 Zhengmin Road, Shanghai 200433, People's Republic of China.

出版信息

Lung Cancer. 2012 Jan;75(1):102-9. doi: 10.1016/j.lungcan.2011.05.023. Epub 2011 Jun 14.

Abstract

BACKGROUND

Single nucleotide polymorphism (SNP) in DNA repair genes can be used to explain the differences in survival of platinum-treated non-small cell lung cancer (NSCLC) patients regardless of their performance status. To define the role of DNA repair gene SNPs in NSCLC patients, we investigated the association between survival and 12 different SNPs of 9 DNA repair genes.

METHODS

340 patients were treated with platinum-based chemotherapy. Polymorphisms were detected by real time PCR with TaqMan probe, using genomic DNA extracted from peripheral blood samples. Multivariate logistic or Cox regression analyses were used to adjust for possible confounding variables.

RESULTS

The median overall survival time was 15 months and it was significantly longer in patients harboring ERCC1 118 C/T or T/T allele: 18 months as compared to 13.8 months for the C/C allele (P=0.014). Subgroup analysis revealed that ERCC1 118 C/T or T/T was associated with increased survival in elderly patients (P=0.018), male (P=0.022), squamous carcinoma (P=0.003), smoker (P=0.076) and those treated with non-gemcitabine/cisplatin or carboplatin (non-GP/GC) regimen (P=0.023). XRCC3C/C was associated with better survival in non-gemcitabine/cisplatin treated patients (P=0.014). Both of CCNH-V270A C/C or C/T and XPD 751 A/A showed a significant longer survival in the squamous cell carcinoma subgroup (P=0.047 and P=0.034 respectively).

CONCLUSION

Present data indicates that ERCC1 118 C/T or T/T might provide a better prognostic predictive marker of NSCLC patients treated with platinum-based chemotherapy, mainly in elderly subgroup, male, squamous carcinoma, smoker and those treated with non-GP/GC regimen.

摘要

背景

DNA 修复基因中的单核苷酸多态性(SNP)可用于解释铂类治疗的非小细胞肺癌(NSCLC)患者生存差异,而不论其表现状态如何。为了确定 DNA 修复基因 SNP 在 NSCLC 患者中的作用,我们研究了生存与 9 个 DNA 修复基因中的 12 个不同 SNP 之间的关系。

方法

340 名患者接受了铂类化疗。使用从外周血样本中提取的基因组 DNA,通过实时 PCR 和 TaqMan 探针检测多态性。使用多变量逻辑或 Cox 回归分析来调整可能的混杂变量。

结果

中位总生存时间为 15 个月,携带 ERCC1 118 C/T 或 T/T 等位基因的患者明显更长:18 个月,而 C/C 等位基因的 13.8 个月(P=0.014)。亚组分析显示,ERCC1 118 C/T 或 T/T 与老年患者(P=0.018)、男性(P=0.022)、鳞状细胞癌(P=0.003)、吸烟者(P=0.076)和接受非吉西他滨/顺铂或卡铂(非 GP/GC)方案治疗的患者(P=0.023)的生存增加相关。XRCC3C/C 与非吉西他滨/顺铂治疗患者的更好生存相关(P=0.014)。CCNH-V270A C/C 或 C/T 和 XPD 751 A/A 在鳞状细胞癌亚组中均显示出更长的生存时间(P=0.047 和 P=0.034)。

结论

目前的数据表明,ERCC1 118 C/T 或 T/T 可能为接受铂类化疗的 NSCLC 患者提供更好的预后预测标志物,主要在老年亚组、男性、鳞状细胞癌、吸烟者和接受非 GP/GC 方案治疗的患者中。

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