Yang Jian, Zheng Wei, Xu Zhi, Chen Jinfei
Department of Oncology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, People's Republic of China.
Department of Oncology, The Affiliated Yixing Hospital of Jiangsu University, Yixing 214200, People's Republic of China.
Onco Targets Ther. 2019 Aug 22;12:6843-6855. doi: 10.2147/OTT.S205438. eCollection 2019.
For patients with gastric cancer (GC), adjuvant chemotherapy is a standard therapy. However, the responses to the treatment are quite different. Mitogen-activated protein kinase (MAPK) pathway is a core pathway that modulates the efficacy of anticancer drugs. The purpose of our study was to investigate the clinical significance of one pivotal functional gene polymorphism in the MAPK pathway - MAP3K1 rs889312 - in patients with stage II GC to stage III GC.
The genotypes of MAP3K1 rs889312 were analyzed in 591 GC patients enrolled in this study who had received radical gastrectomy. Among them, 204 patients accepted adjuvant chemotherapy based on platinum and fluorouracil (PF) regimens after an operation. Cox regression analysis, log-rank test and Kaplan-Meier method were used to explore the link between MAP3K1 rs889312 variant and overall survival (OS) of GC.
Compared with the AA genotype (mean OS of 68.12 months), MAP3K1 rs889312 AC/CC significantly reduced the mean OS of 56.83 months in patients who received adjuvant chemotherapy only. In addition, AC/CC genotype had a negative impact on OS of patients who received oxaliplatin-based therapy (HR, 8.253; 95% CI: 1.119-60.853, log-rank =0.013). Stratification analysis showed that MAP3K1 rs889312 AC/CC significantly reduced OS of patients with tumors smaller than or equal to 5 cm in size (HR, 3.706; 95% CI: 1.329-10.335, =0.012), poorly differentiated tumors (HR, 3.002; 95% CI: 1.076-8.377, =0.036) and intestinal tumors (HR, 4.780; 95% CI: 1.138-20.073, =0.033).
Our findings suggested that MAP3K1 rs889312 single-nucleotide polymorphism may be considered as a biomarker for adjuvant chemotherapy reaction and can predict prognosis of GC patients who received PF-based therapy.
对于胃癌(GC)患者,辅助化疗是标准治疗方法。然而,患者对该治疗的反应差异很大。丝裂原活化蛋白激酶(MAPK)通路是调节抗癌药物疗效的核心通路。我们研究的目的是调查MAPK通路中一个关键功能基因多态性——MAP3K1 rs889312——在II期至III期GC患者中的临床意义。
对本研究中591例接受根治性胃切除术的GC患者的MAP3K1 rs889312基因型进行分析。其中,204例患者术后接受了基于铂和氟尿嘧啶(PF)方案的辅助化疗。采用Cox回归分析、对数秩检验和Kaplan-Meier方法探讨MAP3K1 rs889312变异与GC患者总生存期(OS)之间的联系。
与AA基因型(平均OS为68.12个月)相比,MAP3K1 rs889312的AC/CC基因型显著降低了仅接受辅助化疗患者的平均OS,为56.83个月。此外,AC/CC基因型对接受奥沙利铂治疗患者的OS有负面影响(风险比[HR],8.253;95%置信区间[CI]:1.119 - 60.853,对数秩 = 0.013)。分层分析显示,MAP3K1 rs889312的AC/CC基因型显著降低了肿瘤大小小于或等于5 cm的患者(HR,3.706;95% CI:1.329 - 10.335,P = 0.012)、低分化肿瘤患者(HR,3.002;95% CI:1.076 - 8.377,P = 0.036)和肠型肿瘤患者(HR,4.780;95% CI:1.138 - 20.073,P = 0.033)的OS。
我们的研究结果表明,MAP3K1 rs889312单核苷酸多态性可被视为辅助化疗反应的生物标志物,并可预测接受基于PF方案治疗的GC患者的预后。