ERCC1基因多态性与晚期非小细胞肺癌患者铂类化疗疗效的关系

背景与目的有关ERCC1基因多态性是否影响接受含铂化疗的晚期非小细胞肺癌患者疗效及生存的研究结果不相一致。本研究前瞻性研究90例接受含铂方案化疗的初治晚期非小细胞肺癌患者ERCC1基因C8092A和第118位密码子多态性与疗效的关系。方法全部患者均接受含铂联合方案化疗,采用测序法对患者基因型进行分型,比较不同基因型与疗效的关系。结果ERCC1C8092A基因型频率分别为CC40.0%(36/90)、CA48.9%(44/90)、AA11.1%(10/90),第118密码子基因型频率分别为CC58.9%(53/90)、CT34.4%(31/90)、TT6.7%(6/90)。C8092ACC基因型有效率与CA、AA基因型无统计学差异(33.3%vs29.6%,P=0.71),ERCC1118CC基因型患者有效率与CT和TT基因型无统计学差异(32.1%vs24.3%,P=0.43)。C8092ACC基因型患者与CA和AA基因型PFS无统计学差异(5.2个月vs5.4个月,P=0.62),ERCC1118CC基因型患者CT和TT基因型PFS无统计学差异(5.5个月vs5.3个月,P=0.59)。结论ERCC1C80...     

Blood-based biomarkers for monitoring antiangiogenic therapy in non-small cell lung cancer

Tumor angiogenesis pathways have been identified as important therapeutic targets in non-small cell lung cancer. However, no biomarkers have been described as predictors of response to antiangiogenic therapy in these patients. In this study, plasma levels of VEGF, bFGF, E-selectin, and S-ICAM and gene expression profiles of peripheral blood mononuclear cells from non-small cell lung cancer patients treated with chemotherapy plus bevacizumab were analyzed before and after treatment. Values were correlated with clinicopathological characteristics and treatment response. Plasma factor levels were measured using commercially available ELISA kits. The TaqMan^® human angiogenesis array was used to investigate the effect of treatment on gene expression profiles. Kyoto Encyclopedia of Genes and Genomes and Gene Ontology enrichment analysis was performed for differentially expressed genes using WEB-based GEne SeT AnaLysis Toolkit. Our results suggest a benefit for patients with increased plasma levels of VEGF, E-selectin, and S-ICAM in the course of bevacizumab treatment. Also, we identified differentially expressed genes between paired blood samples from patients before and after treatment, and significantly perturbed pathways were predicted. These changes in gene expression and levels of plasma factors could be used to assess the effectiveness of antiangiogenic therapy, in addition to standard clinical and radiological evaluations.     

DNA损伤修复基因XRCC1和XPD遗传多态与晚期非小细胞肺癌对铂类药物的敏感性

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XRCC1 Arg194Trp和XPD Lys751Gln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XPD Lys751Gln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,XRCC1 Arg194Trp和XPD Lys751Gln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XRCC1 Arg194Trp和XPDLys751Gin遗传多态可能与NSCLC铂类药物敏感性有关。     

Molecular profiling of non-small cell lung cancer and correlation with disease-free survival

Recent studies have suggested that information from gene expression profiles could be used to develop molecular classifications of cancer. We hypothesized that expression levels of specific genes in operative specimens could be correlated to recurrence risk in non-small cell lung cancer (NSCLC). We performed expression profiling using 19.2 K cDNA microarrays on tumor specimens from a total of 39 NSCLC patients with known clinical follow-up information. Statistical analysis and clustering approaches were used to determine patterns of gene expression segregating with clinical outcome. The results provide evidence that molecular subtyping of NSCLC can identify distinct profiles of gene expression correlating with disease-free survival.     

Expression and Prognostic Significance of Multidrug Resistance Associated Protein (MRP) Gene in Non-small Cell Lung Cancer by in Site Hybridization

It has been a hot spot in molecular biology to research the mechanism of multi-drug resistance and its reverse.[1] In the present study, we had examined MRP gene mRNA overexpression on the paraffin-embedded tissues that suffering from NSCLC using in situ hybridization labeled with digoxigenin probes combined with immunohistochemistry. All the patients were retrospectively followed-up. To research the relationship between MRP gene overexpression on NSCLC and the histology, tumor size, n…     

Pharmacogenomic research and serum DNA analysis in the treatment of non-small cell lung cancer

Various genetic alterations have been identified as crucial to both carcinogenesis and prognosis, including several mutational patterns, loss of heterozygosity, and gene overexpression. These alterations have been shown to correlate with mechanisms of resistance to certain cytotoxic agents used in the treatment of non-small-cell lung cancer. This article reviews various aspects of taxane resistance and the relative importance of p53 and ras mutations. Paclitaxel resistance is related to β-tubulin mutations. Genetic alterations can be detected in plasma or serum DNA of patients. Finally, the article discusses the genetic objectives of a european protocol for neoadjuvant and adjuvant chemotherapy in lung cancer.      

原位分子杂交检测肺癌组织MRP基因表达及意义

目的　研究多药耐药性相关蛋白基因 MRP基因 (multi drugresistanceassociatedproteingene ,MRPgene)对肺癌患者预后的影响。方法　应用地高辛抗体标记探针原位分子杂交结合免疫组化技术 ,检测 47例非小细胞肺癌 (NSCLC)根治术后石蜡组织标本中肺癌细胞MRP基因mRNA表达 ,并回顾性随访。结果　 47例组织标本中 ,肺癌细胞均有不同程度MRP基因mRNA过度表达 ,其表达水平与患者术后生存期、化疗疗效、复发及转移密切相关 ,与病理类型、肿瘤大小、淋巴结转移、病理分期、癌细胞分化程度、年龄、性别无明显相关性。结论　MRP基因与肺癌患者预后有密切相关性 ,检测MRP基因mRNA表达水平可作为预测肺癌患者预后、确定化疗方案的手段之一。     

驱动基因阴性的晚期非小细胞肺癌维持治疗进展

肺癌是全球常见的致死率最高的恶性肿瘤。越来越多的研究表明,对于晚期非小细胞肺癌一线治疗后没有进展的患者,维持治疗使患者无进展生存期和总生存期明显获益。传统上对于没有检测到驱动基因的非小细胞肺癌患者,仅能接受化疗,其有效性低,且副作用大,寻找更加有效的治疗方案迫在眉睫。随着新药的层出不穷,本文对如何优化驱动基因阴性的晚期非小细胞肺癌患者的维持治疗,从而提高患者生存期作一综述。     

实时定量PCR 2-△△Ct法检测非小细胞肺癌HER2基因的过表达

背景与目的正确评价HER2基因表达的状况对于肿瘤的施治具有重要的指导意义。以往的评价大多基于免疫组织化学法,但结果变异性大。本研究旨在探讨实时定量PCR 2^-△△Ct法检测非小细胞肺癌（non-small celllung cancer,NSCLC）HER2基因表达的可行性。方法采用实时定量PCR 2^-△△Ct法同时检测212例肺癌组织和与其匹配的非肿瘤组织HER2基因的表达,评价过表达水平。结果肺癌组织中HER2基因的表达水平高于非肿瘤组织（T=67,P<0.05）,HER2基因的过表达率为34.0%。结论实时定量PCR2^-△△Ct法用于检测NSCLCHER2基因的表达是可行的     

Les poisons du fuseau

Spindle poisons form a group of natural substances sharing a common target, the mitotic spindle along which chromosomes migrate to newly formed cells during mitosis. Vinca-alkaloids (vinblastine, vincristine, vindesine, and vinorelbine) inhibit tubulin polymerisation into microtubules, while taxanes (paclitaxel and docetaxel) inhibit microtubule depolymerisation into tubulin. Resistance to spindle poisons may be associated with the overexpression of P-glycoprotein, which can expel them from the cell, and to tubulin isoform alterations that lead to changes in tubulin stability. Vinca-alkaloids are mainly active against childhood cancers, germ-cell tumours and breast cancer, while taxanes have been approved for the treatment of ovarian, breast and non-small cell lung cancers.     

非小细胞肺癌NP方案化疗敏感性与DNA修复基因XRCC1多态性的关系

背景与目的:基因多态预测肿瘤化疗药物敏感性对肿瘤个体化治疗具有重要意义。本研究旨在探讨DNA修复基因XRCC1 codon194及399位点基因多态性与非小细胞肺癌长春瑞滨加顺铂(vinorelbine and cisplatin,NVB and DDP,NP)方案化疗敏感性的关系。方法:采用聚合酶链反应-限制性片段长度多态性技术检测164例非小细胞肺癌患者外周血DNAXRCC1194和399位点的多态性。选择NP方案化疗,化疗两周期后评价疗效,并分析化疗敏感性与基因多态性的关系。结果:携带XRCC1基因Codon194C/T+T/T基因型者化疗有效率(41.8%)是C/C基因型者(26.0%)的2.038倍(P=0.036,95%CI=1.044-3.976)。携带XRCC1基因Codon399G/G、A/G、A/A型的患者化疗有效率(37.1%,34.6%,14.3%)之间的差异无统计学意义(P>0.05)。应用分析软件SHEsis发现以     

晚期非小细胞肺癌化疗的分子预后研究

晚期非小细胞肺癌的标准治疗是以铂类为基础的联合化疗,化疗的疗效达到平台。药理遗传学和药理基因组学的研究显示,患者个体基因多态性及肿瘤组织的基因表达与化疗的疗效和/或毒性反应相关。本文回顾基因表达作为晚期非小细胞肺癌化疗疗效预测因子的临床研究现状。     

单核苷酸多态性与肺癌化疗疗效及预后相关研究进展

单核苷酸多态性（single nucleotide polymorphism，SNP），指基因组DNA序列中频率大于1％的单个核苷酸的变异，这种变异有时导致其编码的蛋白结构和功能发生改变，从而影响其生物学功能。在肿瘤治疗领域表现为不同SNP基因型患者对治疗发生不同的反应．目前SNP与非小细胞肺癌疗效相关研究的主要基因包括DNA切除修复基因、基质金属蛋白酶基因、凋亡相关基因、药物代谢相关基因、细胞周期渊控綦因等。我们就SNP与肺癌化疗的疗效以及预后的相关性进行了综述。     

A comprehensive study of polymorphisms in ABCB1, ABCC2 and ABCG2 and lung cancer chemotherapy response and prognosis

ATP-binding cassette (ABC) transporter expression and genetic heterogeneity have been implicated in response to anticancer therapy. This study characterized genetic variability of the ABCB1 (also known as MDR1), ABCC2 (MRP2) and ABCG2 (BCRP) genes, which are key players in the metabolism of many chemotherapeutic agents including those used in the treatment of lung cancer. We genotyped 53 polymorphisms in the candidate genes in genomic DNA samples of 171 cases of small cell lung carcinoma (SCLC) and 206 cases of non-small cell lung carcinoma (NSCLC), and studied their impact on early response to chemotherapy, progression-free survival and overall survival. SNP rs717620 in ABCC2 was moderately associated with a poor response to chemotherapy but strongly with shorter progression-free survival and overall survival in SCLC but not NSCLC patients, indicating that ABCC2 genetic variation is an important factor in SCLC survival after chemotherapy.     

DNA修复基因多态性与肺癌易感性的研究进展

肺癌的发生与个体遗传易感性有关, 其中DNA修复基因多态性可以引起不同DNA损伤反应, 而机体间DNA损伤修复能力的不同与肺癌的发生有密切联系。DNA修复基因多态性与肺癌易感性的关系已成为当前的研究热点。本文回顾了DNA修复基因的作用机制及其多态性与肺癌易感性的国内外研究现状, 就DNA损伤和修复类型、DNA不同修复途径相关基因的作用机制及其多态性与肺癌易感性的关系、DNA修复基因多态性与肺癌化疗敏感性的关系几个方面进行综述。      

Association of genetic polymorphisms in the base excision repair pathway with lung cancer risk: a meta-analysis

Lung cancer is a major cause of cancer-related death in the developed countries and the overall survival rate has still an extremely poor. Although cigarette smoking is the main cause of lung cancer, not all smokers develop lung cancer, and a fraction of lifelong non-smokers will die from lung cancer. Genetic host factors have recently been implicated to account for some of the observed differences in lung cancer susceptibility. Various DNA alterations can be caused by exposure to environmental and endogenous carcinogens. Most of these alterations, if not repaired, may result in genetic instability, mutagenesis and cell death. DNA repair mechanisms are important for maintaining DNA integrity and preventing carcinogenesis. Recent genetic association studies on lung cancer risk have focused on identifying effects of single nucleotide polymorphisms (SNPs) in candidate genes, among which DNA repair genes are increasingly studied. Genetic variations in DNA repair genes are thought to modulate DNA repair capacity and are suggested to be related to lung cancer risk. We identified a sufficient number of epidemiologic studies on lung cancer to conduct a meta-analysis for genetic polymorphisms in nucleotide base repair (BER) pathway, focusing on 8-oxoguanine DNA glycosylase 1, X-ray cross-complementing group 1 (XRCC1) and apurinic/apyrimidinic endonuclease 1. The 399Gln/Gln genotype of the XRCC1 Arg399Gln polymorphism was associated with an increased risk of lung cancer among Asians (OR=1.34, 95% CI=1.16-1.54) but not among Caucasians. Little evidence of associations has been found between other BER genes and lung cancer risk. Considering the data available, it can be conjectured that if there is any risk association between single SNP and lung cancer, this risk increase/decrease will probably be minimal. Advances in identification of new polymorphisms and in high-throughput genotyping techniques will facilitate analysis of multiple genes in multiple DNA repair pathways. Therefore, it is likely that the defining feature of future epidemiologic studies will be the simultaneous analysis of large samples of cases and controls.     

Molecular pathogenesis of lung cancer and potential translational applications

Molecular studies of lung cancer using individual genes and global approaches of gene analysis have shown several observations that are ready to be translated into clinically useful information to provide new methods of diagnosis, risk assessment, prevention, and treatment. Clinically evident lung cancers have acquired 20 or more clonal genetic alterations, and tumor acquired promoter hypermethylation is a frequent epigenetic mechanism of inactivation of gene expression in lung cancer giving at least another 10-20 lesions. Furthermore, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) have acquired different genetic and epigenetic lesions. Alterations in 3p tumor suppression genes (TSGs) appear especially early, including those of RASSF1A and SEMA3B at 3p21.3, followed by changes in 9p (p16), 8p, and then multiple other sites. Changes consistent with oxidative damage leading to mitotic recombination are frequently seen. Smoking-damaged, histologically normal epithelium as well as epithelium with preneoplastic/preinvasive changes have thousands of clonal patches containing genetic alterations. Finally, correcting even single genetic abnormalities can reverse the malignant phenotype.     

CYP3A5基因多态性与晚期非小细胞肺癌紫杉醇化疗敏感性关系的研究

[目的]探讨CYP3A5基因多态性与晚期非小细胞肺癌紫杉醇化疗敏感性的关系。[方法]对接受以紫杉醇为基础化疗方案进行化疗的60例晚期非小细胞肺癌患者,采用PCR-RFLP方法检测外周血CYP3A5＊1/＊3基因多态性,比较不同基因型之间紫杉醇化疗近期疗效的差异。[结果]60例患者中,CYP3A5基因为＊1/＊1、＊1/＊3和＊3/＊3型的患者数分别有6例（10.00%）、20例（33.33%）和34例（56.67%）。＊1/＊1和＊1/＊3基因型患者的有效率为19.23%,＊3/＊3基因型患者的有效率为55.88%,＊1/＊1和＊1/＊3基因型患者的有效率明显低于＊3/＊3基因型患者（P=0.004）。[结论]对非小细胞肺癌患者治疗前进行CYP3A5基因型的测定,可预测紫杉醇的化疗疗效。     

拓僖为主的联合化疗治疗晚期非小细胞肺癌

目的观察拓僖为主的化疗方案治疗晚期非小细胞肺癌的近期疗效.方法使用拓僖 艾恒(奥沙利铂)方案治疗晚期非小细胞肺癌患者20例.结果完全缓解2例(10.0%),部分缓解6例(30.0%),总有效率(CR PR)为40.0%(8/20).结论拓僖为主的联合化疗方案可作为晚期难治性NSCLC患者化疗的选择方案之一.     

Chromosomal imbalances in human lung cancer

A wealth of cytogenetic data has demonstrated that numerous somatic genetic changes are involved in the pathogenesis of human lung cancer. Despite the complexity of the genomic changes observed in these neoplasms, recurrent chromosomal patterns have emerged. In this review, we summarize chromosomal alterations identified in small cell and non-small cell lung cancer, using classical and molecular cytogenetic techniques. These analyses have uncovered a set of chromosome regions implicated in lung cancer development and progression. However, many of the target genes remain unknown. Newer technology, such as array-CGH, when combined with cDNA microarrays and tissue microarrays, will facilitate the integration of genomic and gene expression data and pave the way toward a molecular classification of lung carcinomas. The molecular implications of consistent chromosome imbalances found in lung cancer to date are also discussed.