DNA修复率与晚期消化道肿瘤含铂化疗方案疗效相关性的研究

发布时间：2018-01-14 19:03

本文关键词：DNA修复率与晚期消化道肿瘤含铂化疗方案疗效相关性的研究　出处：《临床肿瘤学杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨晚期消化道恶性肿瘤患者外周血淋巴细胞(PBLC)的DNA修复率(DRR)与含铂联合化疗方案疗效的关系。方法通过单细胞凝胶电泳法检测112例晚期消化道恶性肿瘤患者(肿瘤组)PBLC的DRR,另选取60例健康体检者作为对照(对照组)。肿瘤组患者均接受含铂联合化疗方案治疗并评价近期疗效,分析两组铂类暴露前与暴露修复后的DRR及肿瘤组DRR与临床病理特征及含铂联合化疗方案疗效的相关性。结果利用尾长(TL)和尾相(TM)检测食管癌(Z=-4.687,P=0.000;Z=-4.939,P=0.000)、胃癌(Z=-5.473,P=0.000;Z=-3.789,P=0.000)及结直肠癌(Z=-5.796,P=0.000;Z=-5.206,P=0.000)的PBLC DRR均低于对照组。肿瘤组的PBLC DRR与性别、年龄、ECOG评分、嗜酒习惯和组织分化均无关(P0.05)。112例患者中110例可评价疗效,其中食管癌PR 3例、SD 6例、PD 12例,有效率(RR)为14.3%,疾病控制率(DCR)为42.9%;胃癌CR 1例,PR 5例、SD 10例、PD 20例,RR为16.7%,DCR为44.4%;结直肠癌CR 2例、PR 8例、SD 13例、PD 30例,RR为18.9%,DCR为43.4%。以TL作为评价DRR的指标,提示食管癌(r=-0.500,P=0.021)、胃癌(r=-0.546,P=0.001)、结直肠癌(r=-0.362,P=0.008)的DRR与化疗疗效均呈负相关,而以TM作为评价DRR的指标则提示食管癌(r=-0.481,P=0.027)和胃癌(r=-0.361,P=0.030)与化疗疗效呈负相关,而结直肠癌(r=-0.256,P=0.064)的DRR与化疗疗效无关。结论消化道恶性肿瘤患者较健康者DNA修复能力低;DRR与晚期食管癌、胃癌患者含铂联合化疗方案的近期疗效呈负相关。
[Abstract]:Objective to investigate the DNA repair rate of peripheral blood lymphocytes (PBLC) in patients with advanced gastrointestinal malignancies. Methods DRR was detected by single cell gel electrophoresis in 112 patients with advanced gastrointestinal malignancies (tumor group). Another 60 healthy persons were selected as control group (control group). All patients in tumor group were treated with platinum-containing chemotherapy regimen and the short-term curative effect was evaluated. To analyze the correlation between DRR before and after exposure and repair in both groups, and between DRR and clinicopathological features of the tumor group and the efficacy of platinum-containing chemotherapy regimen. The results were as follows: 1. P0. 000; The results were as follows: (1) ZGW was 0.000, and the gastric cancer was ZJ-5.473, P0. 000; ZH3. 789 (P < 0. 000) and colorectal cancer (P < 0. 000- 5. 796); PBLC DRR and sex, age and ECOG score in tumor group were lower than those in control group. There was no correlation between alcoholism and tissue differentiation in 110 of 112 patients, including 3 cases of PR and 6 cases of PD. The effective rate (RR) and the disease control rate (DCR) were 14.3and 42.9, respectively. CR 1 case PR 5 cases SD 10 cases PD 20 cases RR 16.7and DCR 44.4; CR 2 cases PR 8 cases SD 13 cases PD 30 cases RR 18.9DR 43.4. TL was used to evaluate DRR. It is suggested that the carcinoma of the esophagus is r-0.500, the carcinoma of the stomach is r-0.546, the carcinoma of the stomach is 0.001, and the carcinoma of colorectal cancer is r-0.362. The DRR of P0. 008) was negatively correlated with the curative effect of chemotherapy, while TM was used as an index to evaluate DRR. There was a negative correlation between the chemotherapeutic effect and the effect of chemotherapy, but there was a negative correlation between the chemotherapy efficacy and the cancer of colorectal cancer (P < 0. 027) and gastric cancer (P < 0. 361P = 0. 0256). Conclusion the DNA repair ability of patients with digestive tract malignant tumor is lower than that of healthy people. DRR was negatively correlated with the short-term efficacy of platinum-containing chemotherapy regimen in patients with advanced esophageal and gastric cancer.
【作者单位】：安徽医科大学第一附属医院肿瘤内科;
【分类号】：R735
【正文快照】： 消化系统肿瘤中约98%为恶性肿瘤,而消化道肿瘤又以食管癌、胃癌和大肠癌多见,小肠癌极少发生。目前,含顺铂或奥沙利铂的化疗方案在晚期消化道肿瘤中的应用已得到普遍认可。铂类药物主要是通过与DNA形成链间或链内交联,抑制DNA的复制、转录,进而导致肿瘤细胞的死亡或凋亡[1]。

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