晚期非小细胞肺癌患者XPD基因多态性与铂类药物化疗临床疗效相关性的Meta分析

发布时间：2018-03-16 08:35

  本文选题：XPD基因多态性　切入点：晚期非小细胞肺癌　出处：《中国药房》2016年24期 　论文类型：期刊论文

【摘要】：目的:系统评价晚期非小细胞肺癌(NSCLC)患者XPD Lys751Gln(A/C)和XPD Asp312Asn(G/A)多态性与以铂类药物为基础的联合化疗临床疗效的相关性,为临床提供循证参考。方法:计算机检索Pub Med、Cochrane图书馆、EMBase、Medline、相关期刊论文、中文科技期刊数据库和万方数据库,收集有关NSCLC患者XPD Lys751Gln和XPD Asp312Asn多态性对以铂类药物为基础的联合化疗的有效性、临床结局和不良反应影响的研究,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入30项研究,合计5 028例患者。基因检测结果发现,XPD Lys751Gln分为变异型基因组(Lys/Gln+Gln/Gln)和野生型基因组(Lys/Lys),XPD Asp312Asn分为变异型基因组(Asp/Asn+Asn/Asn)和野生型基因组(Asp/Asp)。Meta分析结果显示,XPD Lys751Gln多态性中携带变异型基因组患者的无疾病进展生存期(PFS)明显低于携带野生型基因组的患者[MD=-1.12,95%CI(-1.73,-0.50),P0.001],而化疗有效性(TR)和总生存期(OS)比较差异无统计学意义。XPD Asp312Asn多态性中携带变异型基因组患者的TR显著低于携带野生型基因组的患者[OR=0.80,95%CI(0.68,0.96),P=0.02],而PFS和OS比较差异均无统计学意义。安全性方面,XPD Lys751Gln多态性中携带变异型基因组患者的Ⅲ~Ⅳ级胃肠道不良反应发生率显著高于携带野生型基因组的患者[OR=0.43,95%CI(0.20,0.94),P=0.03),而Ⅲ~Ⅳ级血液系统不良反应发生率比较差异无统计学意义。结论:XPD Lys751Gln多态性与晚期NSCLC患者以铂类药物为基础的化疗的PFS和Ⅲ~Ⅳ级胃肠道不良反应有关,而XPD Asp312Asn多态性与以铂类药物为基础的化疗的有效性有关,两个位点均可作为预测NSCLC患者采用以铂类药物为基础的化疗治疗效果的考察靶点。
[Abstract]:Objective: to systematically evaluate the relationship between the polymorphism of XPD Lys751GlnntA / C) and XPD Asp312AsnA- G _ (-P _ (A)) in patients with advanced non-small cell lung cancer (NSCLC) and the clinical efficacy of platinum-based combined chemotherapy. Methods: the Pub Medsite Cochrane Library, the full text Database of Chinese Journals, the Chinese Sci-tech Journals Database and the Wanfang Database were searched by computer. The effects of XPD Lys751Gln and XPD Asp312Asn polymorphisms on the efficacy, clinical outcome and adverse reactions of platinum-based combination chemotherapy in patients with NSCLC were studied. Meta analysis was carried out with Rev Man 5.3 statistical software. Results: 30 studies were included. A total of 5 028 patients were enrolled in this study. The results of gene analysis showed that XPD Lys751Gln was divided into mutant genome Lys / Gln / Gln / Gln) and wild type genome Lys / Lysn / Asp312Asn into mutant genome AspP / Asn / AsnP / Asn. Meta-analysis of wild type Lys751Gln showed mutation in Lys751Gln polymorphism. The progression free survival time (PFSs) of patients with heterogeneous genomes was significantly lower than that of patients with wild type genomes [MD-1.12129CI-1.73CI-0.50P0.001], but there was no significant difference between the efficacy of chemotherapy and total survival time. XPD Asp312Asn polymorphism carried variant genomes. The tr of patients with wild genomes was significantly lower than that of patients with wild type genomes [ORX 0.80 / 9595], but there was no significant difference between PFS and OS. In terms of safety, adverse reactions of 鈪，

本文编号：1619131