| 王琼,肖葛琼,尉理梁.UGT1A1基因多态性与伊立替康治疗结直肠癌的疗效与安全性的关系[J].浙江中西医结合杂志,2018,28(3): |
| UGT1A1基因多态性与伊立替康治疗结直肠癌的疗效与安全性的关系 |
| Relationship between UGT1A1 gene polymorphism and efficacy and safety of irinotecan in the treatment of colorectal cancer |
| 投稿时间：2017-03-14 修订日期：2018-01-05 |
| DOI： |
| 中文关键词: UGT1A1基因 基因多态性 伊立替康 结直肠癌 |
| 英文关键词:: UGT1A1 gene gene polymorphism irinotecan colorectal cancer |
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| 中文摘要: |
| 【】目的：研究UGT1A1基因多态性与伊立替康治疗结直肠癌的疗效和安全性的关系。方法：随机选择2012年8月至2016年9月期间我院收治的采用伊立替康治疗结直肠癌的72例患者作为研究对象,抽取各患者外周血并提取基因组DNA,采用Sanger测序法检测患者UGT1A1*6和UGT1A1*28基因多态性的分布情况,并分析UGT1A1*6和UGT1A1*28基因多态性与伊立替康治疗结直肠癌的疗效和不良反应之间的关系。结果：72例患者中52例UGT1A1*6基因为野生型G/G,占比72.22%；17例UGT1A1*6基因为杂合突变型G/A,占比23.61%；3例UGT1A1*6基因为纯合突变型A/A,占比4.17%。57例UGT1A1*28基因为野生型TA6/6,占比79.17%；14例UGT1A1*28基因为杂合突变型TA6/7,占比19.44%；1例UGT1A1*28基因为纯合突变型TA7/7,占比1.39%。72例接受伊立替康化疗的结直肠癌患者中各UGT1A1基因型疗效和肿瘤进展时间之间的差异没有统计学意义(P＞0.05)。UGT1A1*6突变明显增加3级以上腹泻(χ2=11.71；P=0.00)和中性粒细胞减少的风险(χ2=8.66；P=0.01),而UGT1A1*28突变能够显著提高患者3级以上血小板减少的风险(χ2=16.26；P=0.00)。结论：UGT1A1基因多态性与伊立替康治疗结直肠癌的疗效并没有相关性,但是UGT1A1*6突变明显增加3级以上腹泻和中性粒细胞减少的风险,而UGT1A1*28突变能够显著提高患者3级以上血小板减少的风险,进行UGT1A1基因多态性检测能够为临床用药提供一定的指导。 |
| 英文摘要: |
| Objective: To study the relationship between the polymorphism of UGT1A1 gene and the efficacy and safety of irinotecan in the treatment of colorectal cancer. Methods: Seventy-two patients with colorectal cancer treated with irinotecan in our hospital from August 2012 to September 2016 were selected as the subjects. The peripheral blood was extracted from each patient and the genomic DNA was extracted. Sanger sequencing was used to detect the patients UGT1A1*6 and UGT1A1*28 gene polymorphisms were analyzed, and the relationship between UGT1A1*6 and UGT1A1*28 gene polymorphisms and the efficacy and side effects of irinotecan in the treatment of colorectal cancer was analyzed. Results: Fifty-two cases of UGT1A1*6 were wild-type G/G(72.22%); 17 cases of UGT1A1*6 were heterozygous mutant G/A (23.61%); 3 cases of UGT1A1*6 gene homozygous mutant A/A (4.17%).57 cases of UGT1A1*28 gene were wild type TA6/6 (79.17%); 14 cases of UGT1A1*28 gene was heterozygous mutant TA6/7 (19.44%); 1 case UGT1A1*28 gene homozygous mutant TA7/7 (1.39%). There was no statistically significant difference between the efficacy, tumor progression time and UGT1A1 genotype in 72 patients with colorectal cancer treated with irinotecan (P>0.05). UGT1A1*6 mutation significantly increased above grade 3 diarrhea (χ2=11.71; P=0.00) and neutrophil levels above grade 3 (χ2=8.66; P= 0.01), and UGT1A1*28 mutations could significantly increase the risk of thrombocytopenia in patients with grade 3 or above (χ2= 16.26; P= 0.00). Conclusion: UGT1A1 gene polymorphism has no relationship with the efficacy of irinotecan in treatment of colorectal cancer, however, UGT1A1*6 mutation significantly increased the risk of diarrhea and neutropenia above grade 3, and UGT1A1*28 mutation can significantly improve the risk of grade 3 or above thrombocytopenia, UGT1A1 gene polymorphism detection could provide some guidance for clinical drug use. |
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