晚期胃癌患者外周血ＥＲＣＣ１基因多态性与奥沙利铂疗效相关性的研究

目的：探讨切除修复交叉互补基因１（ＥＲＣＣ１）Ａｓｎ１１８Ａｓｎ（Ｃ→Ｔ，ｒｓ１１６１５）多态性与中国汉族晚期胃癌患者对奥沙利铂一线化疗效果的关系。方法：７１例晚期胃癌患者化疗前抽静脉血提取ＤＮＡ，以ｒｅａｌ-ｔｉｍｅＰＣＲ法对ＥＲＣＣ１基因进行ＳＮＰ分型。患者接受奥沙利铂化疗，观察疾病控制率（ＣＲ＋ＰＲ＋ＳＤ）及至肿瘤进展时间（ＴＴＰ），并比较不同基因型与疗效的关系。结果：４７例Ⅳ期胃癌患者可以评价化疗疗效，疾病控制率为５５.３％，Ｃ／Ｃ与Ｃ／Ｔ＋Ｔ／Ｔ基因型在疾病控制组和无效组之间分布无统计学意义（χ２＝2.７５５，Ｐ＝０.０９７）。７１例晚期胃癌患者中位ＴＴＰ为６个月，Ｃ／Ｔ＋Ｔ／Ｔ基因型患者其中位ＴＴＰ为５个月，与纯合基因型Ｃ／Ｃ中位ＴＴＰ６个月相比，差异无统计学意义（ＯＲ＝０.６１５，Ｐ＝０.０７１）。其中２４例Ⅲ期胃癌患者中位ＴＴＰ为８个月，Ｃ／Ｔ＋Ｔ／Ｔ型患者中位ＴＴＰ为７个月，与纯合基因型Ｃ／Ｃ中位ＴＴＰ８个月相比，差异无统计学意义（ＯＲ＝０.３９７，Ｐ＝０.１１１）。结论：ＥＲＣＣ１Ａｓｎ１１８Ａｓｎ基因多态性与中国汉族晚期胃癌患者接受奥沙利铂一线化疗后的临床效果有相关趋势，需要进一步观察论证。

Research on the clinical outcome of advanced gastric cancer treated with oxaliplatin influenced by ERCC1 gene polymorphism in peripheral blood

Objective：To assess the effect of the polymorphism of ERCC1 Asnll8Asn （C→T,rs11615） on treatment response and TTP of advanced gastric cancer patients treated with oxaliplatin as first-fine chemotherapy regimen. Methods： DNA was extracted from peripheral venous blood before chemotherapy from 71 advanced gastric cancer patients. Real-time PCR was used for genotyping. ERCC1 genotypes were analyzed for associations with disease control response （DCR） and time to progression （＇ITP）. Results：The DCR of 47 stage IV cases was 55. 3%. In this subgroup, patients with C/C genotype did not show distinctly preponderance compared to those with C/T ＋ T/T, between response group （ CR ＋ PR ＋ SD） and un-response group （PD） （ X2 = 2. 755,P = 0. 097）. The median TIP for all 71 patients was 6 months, patients possessing C/C genotype showed a median TIP of 6 months, was not significantly different from 5 months in patients with C/T ＋ T/T genotype（ OR =0. 615 ,P =0. 071 ）. The median TFP for 24 patients in stage m was S months. Among them, patients possessing C/C genotype showed a median TTP of 8 months, slightly differed with 7 months in patients with C/T ＋ T/T genotypes, but the difference was not significant （ OR = 0. 397, P = 0. 111 ）. Conclusion： The results suggest that the ERCCI Asn118Asn genetic polymorphisms may be associated with clinical outcomes of Chinese patients with advanced gastric cancer accepted oxaliplatin as first-line chemotherapy, but need further observation and demonstration.