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目的:探讨DNA修复基因(ERCC1、ERCC2、XRCC1)单核苷酸多态性对胃癌患者卡培他滨联合奥沙利铂化疗敏感性的相关性。方法:本回顾性研究选取XELOX作为一线化疗方案的100例晚期胃癌患者为研究对象,检测分析三个基因六个单核苷酸多态性位点(ERCC1 rs11615;ERCC2 rs13181,rs1799793;XRCC1rs25487,rs25489,rs1799782),同时分析其与临床预后的关系。结果:XRCC1 rs25487的A/G等位基因频率、AG/AA/GG基因分布频率均与疾病化疗敏感性和无进展生存期有关,携带GG基因型患者疗效好(P<0.05),中位PFS为8.00个月(95%CI:6.34~9.66);ERCC2 rs13181的G/T等位基因频率、GG/GT/TT基因分布频率与疾病化疗敏感性和无进展生存期明显相关,携带TT基因型患者疗效好(P<0.05),中位PFS为7.46个月(95%CI:6.45~8.48)。COX比例风险模型显示ERCC2 rs13181 G/T基因型是晚期胃癌无进展生存期的独立风险因素之一(HR=0.72,95%CI:0.53~0.97,P=0.025)。结论:ERCC2 rs13181基因多态性可能是评估接受XELOX化疗晚期胃癌患者预后的关键指标。
Objective: To investigate the association of single nucleotide polymorphisms of DNA repair genes (ERCC1, ERCC2, XRCC1) with chemosensitivity to capecitabine and oxaliplatin in patients with gastric cancer. Methods: The retrospective study of 100 cases of advanced gastric cancer patients treated with XELOX as the first-line chemotherapy regimen was used to detect and analyze six single nucleotide polymorphisms (ERCC1 rs11615, ERCC2 rs13181, rs1799793, XRCC1 rs25487, rs25489 , rs1799782), at the same time analyze its relationship with clinical prognosis. Results: The frequencies of A / G allele and AG / AA / GG gene in XRCC1 rs25487 were all associated with the chemosensitivity and progression-free survival of patients with GG genotype (P <0.05). The median PFS (95% CI: 6.34 ~ 9.66). The frequency of G / T allele and the frequency of GG / GT / TT gene in ERCC2 rs13181 were significantly correlated with chemosensitivity and progression-free survival of patients with TT genotype Patients had good efficacy (P <0.05), and median PFS was 7.46 months (95% CI: 6.45-8.48). The COX proportional hazard model showed that ERCC2 rs13181 G / T genotype was one of the independent risk factors for progression-free survival in advanced gastric cancer (HR = 0.72, 95% CI: 0.53-0.97, P = 0.025). Conclusion: ERCC2 rs13181 gene polymorphism may be the key index for evaluating the prognosis of patients with advanced gastric cancer receiving XELOX chemotherapy.