二氢嘧啶脱氢酶和亚甲基四氢叶酸还原酶基因多态性与卡培他滨方案治疗结直肠癌患者药物不良反应的相关性

发布时间：2018-04-17 19:34

  本文选题：二氢嘧啶脱氢酶 + 亚甲基四氢叶酸还原酶　； 参考：《中国临床药理学杂志》2017年17期

【摘要】：目的分析结直肠癌患者二氢嘧啶脱氢酶(DPYD)和亚甲基四氢叶酸还原酶(MTHFR)基因多态性的分布情况及基因多态性与卡培他滨方案治疗的药物不良反应的相关性。方法回顾性分析我院2015年4月至2016年10月治疗的81例结直肠癌患者DPYD、MTHFR基因型的分布情况,用数字荧光分子杂交(DFMH)技术对患者基因型进行测定。药物不良反应评价按照美国国立癌症研究所常规药物不良反应判定标准3.0(NCI-CTCAE3.0)实施。结果 81例结直肠癌患者DPYD基因检测未发现突变型,而MTHFR基因检测结果分布如下:MTHFR(1298AC)野生型A/A、杂合突变型A/C和纯合突变型C/C分别为57例(70.37%),21例(25.93%)和3例(3.70%)。MTHFR基因纯合突变型(C/C型)和杂合突变型(A/C型)发生Ⅱ~Ⅳ度恶心呕吐风险高于野生型(A/A),分别为33.33%,19.05%和1.75%(P0.05)。MTHFR突变型基因发生Ⅱ~Ⅳ度白细胞减少和血小板减少的风险高于野生型,但差异无统计学意义(P0.05)。结论在我院尚未发现DPYD基因突变型患者,MTHFR基因多态性可以预测卡培他滨方案治疗结直肠癌患者发生药物不良反应的风险。
[Abstract]:Objective to investigate the distribution of dihydropyrimidine dehydrogenase (DPYD) and methylene tetrahydrofolate reductase (MTHFR) gene polymorphisms in patients with colorectal cancer and the relationship between polymorphism and adverse drug reactions (ADR) after capecitabine therapy.Methods the distribution of DPYD- MTHFR genotypes in 81 patients with colorectal cancer treated in our hospital from April 2015 to October 2016 was analyzed retrospectively. The genotypes were determined by digital fluorescent molecular hybridization (DFMH) technique.Adverse drug reaction (ADR) evaluation was performed according to the National Cancer Institute (NCI-CTCAE 3.0) criteria for the determination of adverse drug reactions (NCI-CTCAE 3.0).Results there was no mutation in DPYD gene in 81 patients with colorectal cancer.The results of MTHFR gene detection were as follows: the wild type A / A, the heterozygous mutant A / C and the homozygous mutant C / C were 57 cases (70.37) and 21 cases (25.93%), respectively) and 3 cases (C / C) of homozygous type C (C / C) and heterozygous mutant type (Ac).The risk of vomiting was higher than that of wild type A / A, which was 33.33% and 19.05%, respectively, and the risk of grade 鈪，

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