【摘要】 背景与目的GSTM1参与环境污染物如苯丙芘和其它多环芳烃及抗癌药等的代谢,其多态性是否会影响肺癌患者的化疗效果及预后,国内相关研究比较少,本研究旨在揭示GSTM1多态性是否与化学药物治疗的敏感性有关以及对患者预后的影响。方法采用聚合酶链反应技术,检测接受化学药物治疗的137例原发性肺癌患者GSTM1基因型频率分布情况。结果137例肺癌患者GSTM1缺陷型频率为58.4%(80/ 137),功能型频率为41.6%(57/137);化疗有效组GSTM1缺陷型频率为69.05%(58/84),化疗无效组GSTM1缺陷型频率为41.51%(22/53),二者有统计学差异(P=0.001)。采用铂类化疗方案的患者,化疗有效组GSTM1缺陷型频率为65.43%(53/81),化疗无效组GSTM1缺陷型频率为42%(21/50),二者有统计学差异(P= 0.0025)。对于进展期患者化疗有效组GSTM1缺陷型频率为70.13%(54/77),化疗无效组GSTM1缺陷型频率为41.51%(22/53),二者有统计学差异(P=0.001)。当化疗有效时携带GSTM1功能型的鳞癌、小细胞癌患者生存时间(中位生存期分别为42个月和14个月)比携带GSTM1缺陷型的鳞癌、小细胞癌患者长(中位生存期分别为6个月和7个月)(P<0.05);而腺癌患者,携带GSTM1功能型和缺陷型的生存时间(中位生存期分别为13个月和11个月)差异无统计学意义(P>0.05)。对于化疗无效的患者,不论GSTM1为何种基因型、病理分型如何,患者中位生存期均比较接近,生存时间没有统计学差异(P>0.05)。结论GSTM1缺陷型的患者接受化学药物治疗的效果比GSTM1功能型的患者好;采用铂类化疗方案时GSTM1缺陷型的患者化疗效果比GSTM1功能型的患者好。当化疗有效时,患者生存时间与病理分型、GSTM1基因型相关。更多还原

【Abstract】 Background and objective GSTM1 takes part in the metabolism of environmental pollutants such as benzopyrene,other polycyclic aromatic hydrocarbons and anticancer drugs and so on.The study aims to in- vestigate the relationship between the gene polymorphism of GSTM1 and chemotherapy as well as to study the ef- fect to survival of Chinese patients with lung cancer.Methods The genotypes of GSTM1 were examined with polymerase chain reaction in 137 primary lung cancer patients accepted chemotherapy.Results GSTM1-null genotype frequency was 58.4%(80/137).The frequency of non-null GSTM1 genotype was 41.6%(57/137).The frequency of GSTMl-null genotype was 69.05%(58/84) in the response group of chemotherapy and 41.51%(22/ 53) in the non-response group of chemotherapy.They were significantly different(P=0.001).In the patients with platinum chemotherapy,the frequency of GSTM1-null genotype was 65.43%(53/81) in the response group of chemotherapy and 42%(21/50) in the non-response group.There werestastically differences in them (P=0.0025). For the advanced cases,GSTM1-null genotype frequency was 70.13%(54/77) in the response group of chemotherapy,41.51%(22/53) in the non-response group of chemotherapy respectively and they were signifi- cantly different (P=0.001).When the chemotherapy was effective,the survival time of patients in squamous carcino- ma and small cell carcinoma with non-null GSTM1 genotype(the median survival times were 42 months and 14 months respectively) were longer than those with null GSTM1 genotype(the median survival times were 6 months and 7 months respectively)(P<0.05).The survival time of adencarcinoma with non-null GSTM1 genotype and null GSTM1 genotype(the median survival times were 13 months and 11 months respectively) were comparative(P>0.05).When chemotherapy was not effective,the median survival time were not significantly different(P>0.05). Conclusions The effect of chemotherapy of GSTMl-null genotype patients was better than that of GSTMl-postive genotype patients.The chemotherapy effect of the cases with null GSTM1 type was better than those with non-null GSTM1 type when the patients accepted platinum chemotherapy.When the chemotherapy was effective,the survival time may be related to the histological types and GSTM1 genotypes.更多还原