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中国人羣中,二氢嘧啶脱氢酶基因多态性与氟尿嘧啶为基础的辅助化疗胃癌患者的临床结局。

Polymorphisms of dihydropyrimidine dehydrogenase gene and clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in Chinese population.

机构信息

Department of Hematology and Oncology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu 210009, China.

出版信息

Chin Med J (Engl). 2012 Mar;125(5):741-6.

PMID:22490566
Abstract

BACKGROUND

Dihydropyrimidine dehydrogenase (DPD), a key enzyme involved in the catabolism of 5-fluorouracil (5-FU), is the attractive candidate for pharmacogenetic research on efficacies and toxicities of 5-FU. The aim of this study is to explore the association between polymorphisms of dihydropyrimidine dehydrogenase gene (DPYD) and clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in the Chinese population.

METHODS

Three hundred and sixty-two patients with gastric cancer in the Chinese population were treated with fluorouracil-based adjuvant chemotherapy. The single nucleotide polymorphic genotypes of DPYD were determined by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF-MS) using DNA samples isolated from peripheral blood collected before treatment.

RESULTS

The average response rate for chemotherapy was 46.7%. A significantly different distribution of the rs1801159 (c2=8.76, P=0.012) genotypes was observed. Homozygous genotype rs1801159A/A was over-represented in responsive patients. Conversely, carriers of the rs1801159A/G genotype were prevalent in non-responsive patients. In the haplotype association analysis, there was significant difference in global haplotype distribution between the groups (c2=3.96, P=0.0465).

CONCLUSIONS

These results suggest that polymorphisms of rs1801159 in DPYD may be used as valuable predictors of the response to fluorouracil-based chemotherapy for gastric cancer patients in the Chinese population. Well-designed, comprehensive, and prospective studies on determining these polymorphisms of DPYD as predictive markers for gastric cancer in response to fluorouracil-based therapies are warranted.

摘要

背景

二氢嘧啶脱氢酶(DPD)是参与 5-氟尿嘧啶(5-FU)代谢的关键酶,是 5-FU 疗效和毒性的药物遗传学研究的有吸引力的候选基因。本研究旨在探讨中国人中 DPYD 基因(DPYD)多态性与接受氟尿嘧啶为基础的辅助化疗的胃癌患者临床结局的关系。

方法

362 例中国人胃癌患者接受氟尿嘧啶为基础的辅助化疗。采用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)法,用治疗前外周血 DNA 样本检测 DPYD 的单核苷酸多态性基因型。

结果

化疗的平均缓解率为 46.7%。rs1801159(c2=8.76,P=0.012)基因型的分布有显著差异。rs1801159A/A 纯合基因型在反应良好的患者中过表达。相反,rs1801159A/G 基因型携带者在无反应患者中更为常见。在单体型关联分析中,两组间的总体单体型分布有显著差异(c2=3.96,P=0.0465)。

结论

这些结果表明,DPYD 中的 rs1801159 多态性可能可作为中国人胃癌患者对氟尿嘧啶为基础的化疗反应的有价值的预测因子。有必要设计全面、前瞻性的研究,以确定这些 DPYD 多态性作为预测氟尿嘧啶为基础的胃癌治疗反应的标志物。

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