Leu Martin, Riebeling Theresa, Dröge Leif Hendrik, Hubert Laura, Guhlich Manuel, Wolff Hendrik Andreas, Brockmöller Jürgen, Gaedcke Jochen, Rieken Stefan, Schirmer Markus Anton
Clinic of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein, 24105 Kiel, Germany.
Cancers (Basel). 2021 Jun 4;13(11):2805. doi: 10.3390/cancers13112805.
Despite excellent loco-regional control by multimodal treatment of locally advanced rectal cancer, a substantial portion of patients succumb to this disease. As many treatment effects are mediated via reactive oxygen species (ROS), we evaluated the effect of single nucleotide polymorphisms (SNPs) in ROS-related genes on clinical outcome. Based on the literature, eight SNPs in seven ROS-related genes were assayed. Eligible patients ( = 287) diagnosed with UICC stage II/III rectal cancer were treated multimodally starting with neoadjuvant radiochemotherapy (N-RCT) according to the clinical trial protocols of CAO/ARO/AIO-94, CAO/ARO/AIO-04, TransValid-A, and TransValid-B. The median follow-up was 64.4 months. The Ser326Cys polymorphism in the human OGG1 gene affected clinical outcome, in particular cancer-specific survival (CSS). This effect was comparable in extent to the ypN status, an already established strong prognosticator for patient outcome. Homozygous and heterozygous carriers of the Cys326 variant ( = 105) encountered a significantly worse CSS ( = 0.0004 according to the log-rank test, = 0.01 upon multiple testing adjustment). Cox regression elicited a hazard ratio for CSS of 3.64 (95% confidence interval 1.70-7.78) for patients harboring the Cys326 allele. In a multivariable analysis, the effect of Cys326 on CSS was preserved. We propose the genetic polymorphism Ser326Cys as a promising biomarker for outcome in rectal cancer.
尽管局部晚期直肠癌通过多模式治疗可实现良好的局部区域控制,但仍有相当一部分患者死于该病。由于许多治疗效果是通过活性氧(ROS)介导的,我们评估了ROS相关基因中的单核苷酸多态性(SNP)对临床结局的影响。基于文献,对7个ROS相关基因中的8个SNP进行了检测。符合条件的287例被诊断为UICC II/III期直肠癌的患者,根据CAO/ARO/AIO-94、CAO/ARO/AIO-04、TransValid-A和TransValid-B的临床试验方案,从新辅助放化疗(N-RCT)开始进行多模式治疗。中位随访时间为64.4个月。人类OGG1基因中的Ser326Cys多态性影响临床结局,尤其是癌症特异性生存(CSS)。这种影响在程度上与ypN状态相当,ypN状态是已确立的患者结局的强预后指标。Cys326变体的纯合子和杂合子携带者(n = 105)的CSS明显更差(根据对数秩检验P = 0.0004,多次检验调整后P = 0.01)。Cox回归得出,携带Cys326等位基因的患者CSS的风险比为3.64(95%置信区间1.70 - 7.78)。在多变量分析中,Cys326对CSS的影响依然存在。我们提出基因多态性Ser326Cys作为直肠癌预后的一个有前景的生物标志物。