UGT1A在伊立替康治疗转移性结直肠癌中的疗效与不良反应预测价值

化疗是转移性结直肠癌（mCRC）的主要治疗手段，伊立替康是mCRC的重要药物，但其存在治疗有效率有限、毒副反应个体差异大的问题。因此需要寻找有效的生物学标志物，筛选出对治疗反应性好、耐受性好的个体以指导临床治疗。尿苷二磷酸葡萄糖醛酸转移酶1A（UGT1A）的基因多态性与伊立替康的毒性及疗效均密切相关，但现有研究结果不一致，预测作用存在争议。本文通过Pubmed检索基因多态性与伊立替康相关性的有关文献，综合分析了UGT1A预测伊立替康毒性局限性的原因，可能与人种差异、药物使用剂量不同及与其他化疗药物或靶向药物联合使用有关。UGT1A多位点基因多态性的检测或与羧酸酯酶（CES）、ATP结合盒子（ABC）转运体、CYP3A4、SCOL等多个基因多态性的联合检测可能是提高伊立替康毒性和疗效预测水平的方式之一。

The predictive value of UGT1A gene polymorphism on irinotecan induced toxicity and effect in Chinese me-tastatic colorectal carcinoma

Chemotherapy is dominated treatment measure in metastatic colorectal carcinoma and irinotecan is one of effective chemotherapy drugs. However, the disadvantage of irinotecan is limited effect and varied adverse effects in different patients. So it is of great importance to explore effective bio-markers and screen the patients who potential benefit from irinotecan with good tolerance. The gene polymorphism of UGT1A is closely related to the adverse effects and benefit of irinotecan with controversial analysis results. This review referred the limitation of UGT1A gene polymorphism’s prediction to irinotecan. It might be accounted for ethnicity, dose, drugs used in combination or targeted drugs. It is a more effective pattern to predict the benefit and adverse effects by combined gene polymor-phism examination of CES, ATP blinding cassette transporter, CYP3A4, SCOL and so on.