【摘要】 目的探讨DNA损伤修复基因XRCC1和XPD的遗传多态与晚期非小细胞肺癌(NSCLC)对以铂类为主化疗药物敏感性的关系。方法以聚合酶链反应(PCR)结合限制性片段长度多态性(RFLP),检测200例以顺铂(DDP)或卡铂(CBP)为主要化疗方案的NSCLC患者XRCC1Arg194Trp和XPDLys751Gln多态基因型,并比较不同基因型与化疗敏感性的关系。结果化疗总有效(CR+PR)率为36.0%,其中CR1例,PR71例,SD94例,PD34例。携带XRCC1第194位密码子Arg/Trp或Trp/Trp基因型的个体化疗敏感性是XRCC1第194位密码子Arg/Arg基因型携带者的2.48倍(95%CI为1.36～4.51,P=0.003);未发现XPDLys751Gln多态与化疗敏感性的相关性。联合分析这两个遗传多态发现,XRCC1Arg194Trp和XPDLys751Gln多态在NSCLC对铂类药物敏感性中存在一定的联合作用(趋势检验,P=0.004)。结论XRCC1Arg194Trp和XPDLys751Gln遗传多态可能与NSCLC铂类药物敏感性有关。更多还原

【Abstract】 Objective DNA repair system plays an important role in tumor sensitivity to platinum-based chemotherapy. The purpose of this study was to examine the association between polymorphisms in XRCC1 and XPD, which are involved in DNA repair, and clinical responses to platinum-based chemotherapy in advanced non-small cell lung cancer (NSCLC). Methods XRCC1 Arg194Trp and XPD Lys751Gln were genotyped by PCR-RFLP method in 200 patients with advanced NSCLC who received platinum-based chemotherapy. Unconditional logistic regression model was used to analyze the association between genetic polymorphisms and clinical responses. Results The overall response rate (CR+PR) was 36.0%, including 1 CR, 72 PR, 94 SD and 34 PD. The XRCC1 194Trp allele carriers had higher response rate than the subjects with the Arg/Arg genotype (adjusted OR, 2.48; 95%CI, 1.36-4.51, P=0.003). However, the XPD Lys751Gln polymorphism was not found to be associated with the platinum-based chemotherapy. These two genetic polymorphisms may have some interaction in the drug sensitivity, the P value for the trend was significant (P=0.004). Conclusion Those results suggest that the XRCC1 Arg194Trp and XPD Lys751Gln genetic polymorphisms may be associated with clinical responses to platinum-based chemotherapy in advanced non-small cell lung cancer.更多还原