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筛查预测电针对辅助化疗后乳腺癌疲劳患者疗效的单核苷酸多态性。

Screening Single Nucleotide Polymorphisms Predicting the Efficacy of Electroacupuncture for Fatigue Treatment in Patients with Breast Cancer Following Adjuvant Chemotherapy.

机构信息

Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining, People's Republic of China.

The Fifth People's Hospital of Qinghai Province, The First Ward of Oncology, Xining, 810000, China.

出版信息

Biochem Genet. 2024 Apr;62(2):1291-1303. doi: 10.1007/s10528-023-10477-8. Epub 2023 Aug 18.

DOI:10.1007/s10528-023-10477-8
PMID:37596508
Abstract

Chemotherapy-induced fatigue reduces not only the quality of life of patients but also effect their recurrence-free survival rate. Although electroacupuncture can relieve fatigue, it has limited affect on some patients. Therefore, appropriate biomarkers are needed to help screen patients who can benefit from electroacupuncture treatment of fatigue. We conducted this study to explore the predictive ability of SNPs on the efficacy of electroacupuncture in the treatment of fatigue in patients with breast cancer after adjuvant chemotherapy. Our study included breast cancer patients with fatigue after receiving paclitaxel and/or anthracycline based adjuvant chemotherapy. The patients were divided into the electroacupuncture group and the control group. The electroacupuncture treatment group received adjuvant chemotherapy and electroacupuncture treatment, while the control group only received adjuvant chemotherapy, and then compared the fatigue relief degree of two groups. In addition, we used NCBI dbSNP and PharmGKB databases to select fatigue related genes and their SNPs. We collected peripheral blood from the included patients for SNPs typing, and recorded the efficacy of electroacupuncture to analyzed the correlation between different SNPs and therapeutic efficacy. The side effects of electroacupuncture treatment were also recorded. 76 patients in the electroacupuncture group and 48 patients in the control group were enrolled. In the electroacupuncture group, 63 patients (82.9%) experienced moderate to severe fatigue (BFI score > 3). After electroacupuncture treatment, the number of patients with a BFI score of > 3 was 46 (60.5%). Therefore, the fatigue symptoms of 26.9% patients were significantly improved (P < 0.05). In the control group, which did not receive electroacupuncture treatment, 40 of 48 patients had a BFI score of > 3. Following the same observation time used in the electroacupuncture group, 36 patients had a BFI score of > 3 points. Thus, fatigue was not significantly relieved in the control group (83.3% vs. 75.0%, P > 0.05). We included 56 patients in our analysis of the correlation between SNPs and electroacupuncture treatment effects. We divided the patients into an effective group and ineffective group according to therapeutic effects. Our results indicated that the effective rate of electroacupuncture treatment with IL1A rs3783550 AC and CC genotypes was higher than that with other genotypes (AC: 84.6%, CC: 81.8%, AA: 33.0%, P < 0.05). Similarly, the effective rate of electroacupuncture treatment with HTR1A rs6295 GG and CC genotypes was higher than that with other genotypes (GG: 63.0%, CC: 55.6%, GC: 18.2%, P < 0.05). However, no other genotypes were related to the effect of electroacupuncture treatment on fatigue. Our result showed that electroacupuncture has therapeutic effect on fatigue after adjuvant chemotherapy for breast cancer and the side effects are tolerable. In addition, IL1A rs3763550 and HTR1A rss6295 can predict the therapeutic effect of electroacupuncture on fatigue after adjuvant chemotherapy in breast cancer, which helps to better screen patients who can benefit from electroacupuncture treatment.

摘要

化疗引起的疲劳不仅降低了患者的生活质量,还影响了他们的无复发生存率。虽然电针可以缓解疲劳,但对某些患者的效果有限。因此,需要适当的生物标志物来帮助筛选可以从电针治疗疲劳中受益的患者。我们进行了这项研究,以探讨 SNP 对接受紫杉醇和/或蒽环类药物辅助化疗后的乳腺癌患者电针治疗疲劳疗效的预测能力。我们的研究包括接受紫杉醇和/或蒽环类药物辅助化疗后出现疲劳的乳腺癌患者。患者分为电针组和对照组。电针治疗组接受辅助化疗和电针治疗,而对照组仅接受辅助化疗,然后比较两组的疲劳缓解程度。此外,我们使用 NCBI dbSNP 和 PharmGKB 数据库选择与疲劳相关的基因及其 SNP。我们从纳入的患者中采集外周血进行 SNP 分型,并记录电针的疗效,以分析不同 SNP 与治疗效果的相关性。还记录了电针治疗的副作用。共有 76 名电针组患者和 48 名对照组患者入组。在电针组中,63 名患者(82.9%)有中重度疲劳(BFI 评分>3)。电针治疗后,BFI 评分>3 的患者人数为 46 名(60.5%)。因此,26.9%的患者的疲劳症状明显改善(P<0.05)。在未接受电针治疗的对照组中,48 名患者中有 40 名 BFI 评分>3。在与电针组相同的观察时间后,36 名患者 BFI 评分>3 分。因此,对照组的疲劳没有明显缓解(83.3% vs. 75.0%,P>0.05)。我们对 SNP 与电针治疗效果的相关性进行了 56 例患者的分析。我们根据治疗效果将患者分为有效组和无效组。结果表明,IL1A rs3783550 AC 和 CC 基因型电针治疗的有效率高于其他基因型(AC:84.6%,CC:81.8%,AA:33.0%,P<0.05)。同样,HTR1A rs6295 GG 和 CC 基因型电针治疗的有效率高于其他基因型(GG:63.0%,CC:55.6%,GC:18.2%,P<0.05)。然而,其他基因型与电针治疗对疲劳的疗效无关。我们的结果表明,电针对乳腺癌辅助化疗后疲劳有治疗作用,且副作用可耐受。此外,IL1A rs3763550 和 HTR1A rss6295 可以预测电针治疗乳腺癌辅助化疗后疲劳的疗效,有助于更好地筛选可以从电针治疗中受益的患者。

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