RAD23B基因rs10759225位点多态性与含铂类方案治疗非小细胞肺癌疗效和血液学毒性的关系

目的探讨RAD23B基因rs10759225位点多态性与含铂类方案一线治疗中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效及血液学毒性的关系。方法回顾性收集接受含铂类联合方案一线治疗的150例NSCLC患者的临床资料及外周血样本,采用改良多重高温连接酶检测反应技术对rs10759225进行基因分型,并分析其与患者疗效及血液学毒性的关系。结果 150例NSCLC患者的总有效率(ORR)为28.7%(43/150)。与携带G/G基因型患者比较,携带A等位基因型(G/A和A/A)患者接受含铂类方案治疗的ORR显著提高(OR校正=1.780,95%CI:1.110~2.884,P=0.042)。全组患者中位无进展生存期(mPFS)为5.6个月,各基因型患者的mPFS差异均无统计学意义(P>0.05)。以G/G基因型为参照,A/A基因型与患者化疗后发生Ⅲ/Ⅳ度白细胞减少的风险相关(OR校正=0.468,95%CI:0.204~0.711,P=0.008);A等位基因型分别与患者发生Ⅲ/Ⅳ度中性粒细胞减少(OR校正=0.502,95%CI:0.155~0.887,P=0.022)和≥Ⅰ度血小板减少的风险有关(OR校正=0.494,95%CI:0.101~0.833,P=0.047);而G/A基因型与患者发生Ⅱ/Ⅲ度贫血的风险有关(OR校正=0.504,95%CI:0.213~0.890,P=0.047)。结论 RAD23B基因rs10759225位点多态性与含铂类方案治疗NSCLC的疗效及血液学毒性有关,但与患者的预后无关。与携带G/G基因型患者比较,携带A等位基因型患者的疗效更好,但发生骨髓抑制的风险更高。

Association between RAD23B gene rs10759225 polymorphism and clinical outcomes of non-small cell lung cancer patients treated with platinum-based chemotherapy

XIE Xiaonan;WEN Yiyong;LING Qiongying;HUANG Wenfeng;QIN Fanghui;WANG Hongxue;ZHOU Wenxian;LU Yongkui;XIE Yuan;XIE Weimin(Department of Chemotherapy,the Affiliated Cancer Hospital of Guangxi Medical University,Nanning 530021,China;Guangxi Medical University Graduate School, Nanning 530021 , China;The First People Hospital of Changde City, Changde54100, China;Department of Oncology, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530021 , China)