摘要
目的探讨尿苷二磷酸葡萄糖苷酸转移酶1A1(UGT1A1)基因多态性与以伊立替康为基础的化疗方案治疗小细胞肺癌不良反应及疗效的关系。方法选取接受以伊立替康为基础化疗方案且进行过UUGT1A1基因多态性检测的72例小细胞肺癌患者,分析其用药后的不良反应及疗效,并比较不同UGT1A1^28和基因型患者之间的差异。结果UGT1A1^*28突变型患者迟发性腹泻和骨髓抑制的发生率及严重程度均高于野生型患者,差异均有统计学意义(P<0.05);UGT1A1^*28/^*6单野生型患者迟发性腹泻和骨髓抑制的发生率及严重程度均高于UGT1A1^*28/^*6双野生型患者,差异均有统计学意义(P<0.05)。UGT1A1^*6突变型和野生型患者迟发性腹泻和骨髓抑制的发生率及严重程度比较,差异均无统计学意义(P>0.05)。不同UGT1A1^*28基因型、UGT1A1^96基因型、UGT1A1^*28/^*6基因型小细胞肺癌患者的客观缓解率(ORR)和疾病控制率(DCR)比较,差异均无统计学意义(P>0.05)。结论对于接受以伊立替康为基础化疗方案的小细胞肺癌患者,UGT1A1^*28和基因联合检测对于迟发性腹泻及骨髓抑制等不良反应的发生具有预测价值,但UGT1A1基因多态性不能应用于临床疗效的预测。
Objective To investigate the relationship between the genetic polymorphism in uridine diphosphate glucosyltransferase 1A1(UGT1A1)and the adverse reactions and efficacy of irinotecan-based chemotherapy for small cell lung cancer(SCLC).Method A retrospective analysis was performed for 72 cases of SCLC who were treated with irinotecan-based chemotherapy and had undergone UGT1A1 gene polymorphism detection,to analyze the adverse reactions and the efficacy after treatment,the differences between patients with different genotypes of UGT1A1^*28 or UGT1A1^*6 were compared.Result The incidence and severity of delayed diarrhea and bone marrow suppression in patients with UGT1A1^*28 gene mutation were higher than those in patients with wild-type UGT1A1^*28(P<0.05);the incidence and severity of delayed diarrhea and bone marrow suppression were also higher in patients with single wild-type UGT1A1^*28/^*6 than in those with double wild-type UGT1A1^*28/^*6(P<0.05).However,there was no significant difference for the incidence and severity of delayed diarrhea and bone marrow suppression between UGT1A1*6 mutant type and wild type(P>0.05).The objective response rate(ORR)and disease control rate(DCR)were comparable in SCLC patients with different UGT1A1^*28 genotype,UGT1A1*6 genotype or UGT1A1^*28/^*6 genotype(P>0.05).Conclusion For SCLC patients receiving irinotecan-based chemotherapy,the combined detection of UGT1A1^*28 and UGT1A1*6 is predictive for the occurrence of adverse reactions such as delayed diarrhea and bone marrow suppression,but the UGT1A1 gene polymorphism cannot be used to predict the clinical efficacy.
作者
杨科
郝学志
杜斌
滕菲
乔英凯
郭小花
曹素焕
YANG Ke;HAO Xuezhi;DU Bin;TENG Fei;QIAO Yingkai;GUO Xiaohua;CAO Suhuan(Department of Medical Oncology,Cancer Hospital of Huanxing ChaoYang District Beijing,Beijing 100065,China;Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《癌症进展》
2020年第13期1320-1323,1353,共5页
Oncology Progress
