胸苷酸合成酶基因多态性与晚期非小细胞肺癌化疗敏感性的关系

目的探讨胸苷酸合成酶（TS）基因多态性与晚期非小细胞肺癌（NSCLC）患者对铂类为基础的化疗敏感性的关系。方法 101例晚期NSCLC患者采用顺铂或卡铂为主的方案化疗,2~3个周期后进行临床疗效评价。应用PCR方法分析患者TS 5′-非翻译区（UTR）基因多态性,以非条件logistic回归模型分析不同基因型与化疗敏感性的关系。结果 101例患者的总有效率为30.7%。携带TS 5′-UTR 2R等位基因患者的化疗敏感性是携带TS 5′-UTR 3R/3R基因型患者的1.54倍（95%CI=0.65~3.68,P=0.331）,但无统计学差异。携带3R/3R基因型患者粒细胞减少和恶心、呕吐的化疗毒性反应程度低于3R/2R和2R/2R基因型患者（P〈0.05）。结论 TS 5′-UTR基因可能不是NSCLC铂类药物化疗的独立敏感性预测因子。

Polymorphisms of thymidylate synthase gene and sensitivity to chemotherapy in advanced non-small cell lung cancer

Objective To analyze the association between polymorphisms in thymidylate synthase（TS） and clinical responses to platinum-based chemotherapy in advanced non-small-cell lung cancer（NSCLC）.Methods A total of 101 patients with advanced NSCLC were treated with cisplatin-or carboplatin-based chemotherapy,and clinical response was evaluated after 2 to 3 cycles.TS 5′-UTR genotypes were determined by PCR methods.Unconditional logistic regression model was used to analyze the association between genetic polymorphisms and clinical responses.Results The overall response rate（CR＋PR） was 36.7%.The TS 5′-UTR 2R allele carriers had higher response rate than the subjects with the TS 5′-UTR 3R/3R genotype（adjusted OR： 1.54;95%CI=0.65~3.68,P=0.331）.The incidence rates of granulocytopenia and vomiting/nausea in 3R/3R genotype were significantly lower than those in the other genotypes（P0.05）.Conclusions TS 5′-UTR polymorphism does not seem to have significant role in susceptibility of platin-based chemotherapy in advanced non-small cell lung cancer.