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SLC22A2 基因型对顺铂和氟尿嘧啶治疗的食管癌患者顺铂诱导的肾毒性无影响:与先前研究结果不一致的报告。

Absence of effect of SLC22A2 genotype on cisplatin-induced nephrotoxicity in oesophageal cancer patients receiving cisplatin and 5-fluorouracil: report of results discordant with those of earlier studies.

机构信息

Department of Pharmacy, Akita University Hospital, Akita, Japan.

出版信息

J Clin Pharm Ther. 2013 Dec;38(6):498-503. doi: 10.1111/jcpt.12097. Epub 2013 Sep 16.

Abstract

WHAT IS KNOWN AND OBJECTIVE

Cancer patients treated with cisplatin chemotherapy frequently experience drug-induced nephrotoxicity. Clinical studies using a single chemotherapeutic regimen or large sample sizes for patients with the SLC22A2 808T allele have not been reported. Here, we examined 95 patients with oesophageal cancer who received 5-fluorouracil and cisplatin (FP) to determine whether nephrotoxicity was affected by SLC22A2 808G>T polymorphism.

METHODS

The change rate of the estimated glomerular filtration rate (eGFR) was used for the evaluation of cisplatin-induced nephrotoxicity and calculated for each patient according to the following formula: change rate = (prechemotherapy value - post-chemotherapy value)/prechemotherapy value. Genotyping of SLC22A2 808G>T was carried out using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.

RESULTS

The eGFR after FP chemotherapy was significantly lower than that before chemotherapy, and the mean difference in eGFR was 25·7 mL/min (P < 0·01). There was no significant difference in the mean change rate of the eGFR following FP chemotherapy between the SLC22A2 808GG genotype (n = 70) and the 808GT+TT genotypes (n = 25) (27·9% and 27·8%, respectively). In multiple regression analyses, the change rate of eGFR following FP chemotherapy was associated with the eGFR value prior to chemotherapy (P = 0·04).

WHAT IS NEW AND CONCLUSION

In FP chemotherapy for oesophageal cancers, cisplatin-induced nephrotoxicity seems to be unaffected by the SLC22A2 808G>T polymorphism. The eGFR prior to chemotherapy might be an important risk factor for cisplatin-induced nephrotoxicity. Our present study was estimated with a single chemotherapeutic regimen, eGFR, and was calculated using serum creatinine, age and the sex of the patient and sample sizes of 25 patients with SLC22A2 808T allele. However, further examinations with a larger sample size to corroborate the study results might be necessary.

摘要

已知和目的

接受顺铂化疗的癌症患者经常发生药物诱导的肾毒性。使用单一化疗方案或针对 SLC22A2 808T 等位基因的患者进行大样本量的临床研究尚未报道。在这里,我们检查了 95 名接受 5-氟尿嘧啶和顺铂(FP)治疗的食道癌患者,以确定 SLC22A2 808G>T 多态性是否影响肾毒性。

方法

根据以下公式计算每个患者的顺铂诱导肾毒性的估计肾小球滤过率(eGFR)变化率:变化率=(化疗前值-化疗后值)/化疗前值。使用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法进行 SLC22A2 808G>T 基因分型。

结果

FP 化疗后的 eGFR 明显低于化疗前,eGFR 的平均差异为 25.7 mL/min(P<0.01)。SLC22A2 808GG 基因型(n=70)和 808GT+TT 基因型(n=25)FP 化疗后 eGFR 的平均变化率无显著差异(分别为 27.9%和 27.8%)。在多元回归分析中,FP 化疗后 eGFR 的变化率与化疗前的 eGFR 值相关(P=0.04)。

新内容和结论

在 FP 治疗食道癌的化疗中,顺铂诱导的肾毒性似乎不受 SLC22A2 808G>T 多态性的影响。化疗前的 eGFR 可能是顺铂诱导肾毒性的一个重要危险因素。我们的研究是基于单一的化疗方案、eGFR,并使用血清肌酐、年龄和患者性别以及 25 名 SLC22A2 808T 等位基因患者的样本量进行计算。然而,为了证实研究结果,可能需要进行更大样本量的进一步检查。

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