【摘要】 目的检测转移性结直肠癌患者外周血血管内皮生长因子(vascular endothelial growth factor,VEGF)启动子区域单核苷酸多态性(single nucleotide polymorphism,SNP),探讨VEGF的SNP与患者预后的关系。方法收集2012年1月至2015年12月在本院治疗的60例转移性结直肠癌患者接受化疗前的外周血样本,所有患者均接受标准方案化疗,其中20例加用了贝伐珠单抗。应用质谱分析法,进行3个VEGF启动子区域基因多态性的检测,包括-2578C>A、-460T>C和-1455T>C。结果60例转移性结直肠癌患者,所有患者中位总体生存期(OS)为16.0月;联合贝伐株单抗组的中位OS为34.0月优于单用化疗组的中位OS为12.7月(P=0.004);VEGF各SNP变异率与美国国家生物技术信息中心数据库数据相似,-2578C>A和-460C>T变异具有较高一致性,60例患者中59例在纯合、杂合变异及纯合变异3个方面完全一致(P=0.76);-2578C>A和-460C>T不同变异的总生存期差异无统计学意义(P>0.05),在联合贝伐珠单抗组患者中,-2578C>A和-460T>C的纯合子变异者仍然存活,杂合子变异者3年生存率仅28.6%。结论外周血VEGF启动子部分位点的SNP状态与转移性结直肠癌患者化疗的长期疗效可能相关。更多还原

【Abstract】 Objective To detect single nucleotide polymorphism(SNP)in vascular endothelial growth factor(VEGF)promoter region in metastatic colorectal cancer patients,and explore the relationship between the SNP and prognosis.Methods From January 2012 to December 2015,peripheral blood samples were taken from 60 metastatic colorectal cancer patients before chemotherapy in our hospital.These patients received standard chemotherapy.20 cases received chemotherapy plus bevacizumab.Three SNPs in VEGF promoter region were detected successfully by Mass ARRAY method,including-2578 C>A,-460 T>C and-1455 T>C.We analyzed the relationship between the SNP and prognosis.Results The over survival(OS)was 16 months.In chemotherapy and bevacizumab group the OS was 34.0 months,and it was better than chemotherapy alone group(12.7 months)(P=0.004).The SNP status for each site was similar with national center for biotechnology information(NCBI)database.-2578 C>A and-460 C>T mutation has a high consistency(59/60,98.3%)in the overall patient.Overall survival difference was no significant between the SNP groups(P =0.76).In the patients with application of bevacizumab,-2578 C>A and-460 T>C homozygous mutation all survived,3 years survival rate just was 28.6% in patients with heterozygous mutation.Conclusions In metastatic colorectal cancer,the VEGF promoter SNP status may be related to the long-term efficacy of chemotherapy.更多还原