新疆维吾尔族、汉族CDA基因多态性与吉西他滨治疗非小细胞肺癌疗效的相关性比较研究

发布时间：2018-04-17 20:43

本文选题：非小细胞肺癌 + 胞苷脱氨酶　；参考：《石河子大学》2017年硕士论文

【摘要】：目的:通过检测新疆维吾尔族、汉族非小细胞肺癌患者外周血CDA A79C与G208A位点基因多态性,明确新疆维吾尔族与汉族非小细胞肺癌患者A79C与G208A位点基因型分布及基因频率分布是否有民族差异性,并初步探讨两民族NSCLC患者基因多态性与化疗疗效的相关性,为两民族非小细胞肺癌患者吉西他滨个体化治疗提供理论依据。方法:收集2014年8月至2016年4月在石河子大学医学院第一附属医院肿瘤内科及喀什地区第一人民医院经病理学确诊的晚期NSCLC初治维吾尔族患者53例,汉族患者67例;采用直接测序的方法检测A79C与G208A的基因多态性,所有NSCLC患者均接受含吉西他滨方案的化疗,化疗两周期后评效,分析两民族的基因多态性分布差异及与吉西他滨化疗疗效的相关性。结果:(1)53例维吾尔族、67例汉族NSCLC患者CDA A79C与G208A基因型频率均符合Hardy-Weinberg平衡(P0.05);(2)新疆维吾尔族、汉族NSCLC患者一般临床资料对比,P0.05无统计学差异性;对CDA A79C分析:汉族中突变基因型频率为47.8%,突变等位基因频率为32.8%,维吾尔族中突变基因型频率为24.6%,突变等位基因频率为5.1%,且两组在基因型频率与等位基因频率均有统计学意义(P0.05)。对CDA G208A分析:两组中均未检测出基因型AA,汉族中突变基因型频率为22.4%,突变等位基因频率为11.2%,维吾尔族中突变基因型频率为5.7%,突变等位基因频率为2.8%,且两组在基因型频率与等位基因频率均有统计学意义(P0.05)。(3)在A79C基因AC基因型中,汉族有效率为35%,维族有效率为30%,汉族与维吾尔族NSCLC的临床疗效有统计学差异(P=0.028)。在G208A基因GG基因型中,汉族有效率为55.8%,维族有效率为32%,汉族与维吾尔族NSCLC的临床疗效有统计学差异(P=0.016)。(4)汉族NSCLC患者A79C基因AA、AC、CC基因型化疗有效率分别为65.7%、35%、25%,此基因与化疗疗效有统计学差异(P=0.016)。维吾尔族NSCLC患者A79C基因AA、AC、CC基因型化疗有效率分别为62.5%、30%、0,此基因与化疗疗效有统计学差异(P=0.031)。结论:1.在NSCLC患者中,维吾尔族、汉族CDA A79C与G208A这两个位点的基因多态性存在种族差异性;2.在维、汉两民族非小细胞肺癌患者A79C基因AC基因型与G208A基因GG基因型中,均为汉族疗效优于维吾尔族NSCLC患者疗效。3.维、汉两民族非小细胞肺癌患者A79C多态性与化疗效果密切相关,且AA基因型化疗疗效优于AC、CC基因型的化疗疗效,可能对今后两民族NSCLC患者个体化化疗具有潜在的应用价值,为临床个体化用药提供参考。
[Abstract]:Objective: to detect the polymorphisms of CDA A79C and G208A loci in peripheral blood of Xinjiang Uygur and Han non-small cell lung cancer patients.To determine whether there are ethnic differences in genotype distribution and gene frequency distribution of A79C and G208A loci between Uygur and Han non-small cell lung cancer patients in Xinjiang, and to explore the correlation between gene polymorphism and chemotherapy efficacy in patients with NSCLC.To provide theoretical basis for the individualized treatment of gemcitabine in patients with non-small cell lung cancer (NSCLC).Methods: from August 2014 to April 2016, 53 patients with advanced Uygur nationality and 67 patients with Han nationality who were diagnosed pathologically in Department of Oncology, the first affiliated Hospital of Shihezi University Medical College and the first people's Hospital of Kashi region were collected.The gene polymorphisms of A79C and G208A were detected by direct sequencing. All patients with NSCLC received chemotherapy with gemcitabine regimen, and the efficacy was evaluated after two cycles of chemotherapy.To analyze the difference of gene polymorphism distribution between the two peoples and the relationship between the gene polymorphism and the efficacy of gemcitabine chemotherapy.Results the frequencies of CDA A79C and G208A genotypes in 53 cases of Uygur nationality and 67 cases of Han nationality with NSCLC were in accordance with the frequency of Hardy-Weinberg balance (P0.05P0.05P0.05P0.05P0.05P0.05) there was no significant difference in the general clinical data between Xinjiang Uygur and Han nationality NSCLC patients (P0.05).The analysis of CDA A79C showed that the frequency of mutation genotype was 47.8, the frequency of mutation allele was 32.8in Han nationality, the frequency of mutation genotype was 24.6in Uygur, the frequency of mutation allele was 5.1g, and the frequency of genotype and allele was statistically significant in both groups (P 0.05).Analysis of CDA G208A: no genotypes were detected in the two groups, the frequency of mutation genotype was 22.4in Han nationality, the frequency of mutation allele was 11.2um, the frequency of mutation genotype was 5.7g and the frequency of mutation allele was 2.8in Uygur nationality, and the frequency of mutation allele was 2.8g in the two groups.Type A frequency and allele frequency were statistically significant in A79C gene AC genotype.The effective rates of Han and Uygur were 35 and 30 respectively. The clinical efficacy of NSCLC in Han nationality and Uygur nationality was significantly different from that in Uygur nationality.In the GG genotype of G208A gene,The effective rate of A79C gene in NSCLC patients of Han nationality was 55.8%, and that of Uygur nationality was 325.The effective rate of A79C gene was 55.8% and the effective rate of Uygur nationality was 325.The effective rate of A79C gene was 65.78% and the effective rate of Uygur nationality was 325.The effective rate of A79C gene was 65.7% and 35% (P 0.016%) respectively in NSCLC patients of Han nationality and Uygur nationality, and there was a significant difference between this gene and chemotherapy effect (P0.016).The effective rates of A79C gene ACCC genotype chemotherapy in Uygur NSCLC patients were 62.5% and 30%, respectively. There was statistical difference between A79C gene and chemotherapy effect.Conclusion 1.In NSCLC patients, the genetic polymorphisms of CDA A79C and G208A in Uygur and Han nationality were different from each other.A79C gene AC genotype and G208A gene GG genotype in patients with non-small cell lung cancer (NSCLC) of both nationalities in Uygur and Han nationalities were better than that in Uygur NSCLC patients by using A79C gene AC genotype and G208A gene GG genotype.The A79C polymorphism in patients with non-small cell lung cancer (NSCLC) of both nationalities was closely related to the effect of chemotherapy, and the efficacy of AA genotype chemotherapy was better than that of ACCC genotype, which may have potential application value for individualized chemotherapy in NSCLC patients of both nationalities in the future.To provide a reference for clinical individualized drug use.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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