CAJ | 학술논문

目的：探讨尿苷二磷酸葡萄糖醛基转移酶1家族肽A（UGT1A1）和切除修复交叉互补基因1（ERCC1）基因型对伊立替康联合顺铂治疗复发性卵巢癌患者产生的不良反应和临床效果的相关性。方法提取89例复发性卵巢癌患者血样标本的DNA，确定UGT1A1和ERCC1基因型，研究UGT1A1基因多态性与伊立替康引起的不良反应，ERCC1基因多态性对顺铂疗效的相关性。结果 UGT1A1*28 WW携带者，Ⅱ～Ⅳ度迟发性性腹泻的发生率为52.2％，WM+MM携带者的发生率为72.7％，OR（95%CI ）为2.1（1.6~9.2），两组比较差异有统计学意义（P=0.031）；UGT1A1*28 WW携带者Ⅲ～Ⅳ度迟发性性腹泻的发生率为7.5％，WM+MM携带者的发生率为36.3%，两组比较P=0.000，OR（95%CI ）为4.9（3.3~15.8），差异有统计学意义（P=0.000）；ERCC1 WW携带者，治疗3个周期后的临床收益率为30.3%，ERCC1 WM+MM携带者的临床收益率为20.2%，两组比较P=0.032，OR（95%CI）为3.2（1.4~9.1）。结论 UGT1A1*28是伊立替康迟发性腹泻的靶基因，可增加伊立替康发生严重腹泻的风险；ERCC1 WW基因对复发性卵巢癌患者使用伊立替康联合顺铂治疗较携带ERCC1 WM+MM基因患者能获得更好的临床效果。
목적：탐토뇨감이린산포도당철기전이매1가족태A（UGT1A1）화절제수복교차호보기인1（ERCC1）기인형대이립체강연합순박치료복발성란소암환자산생적불량반응화림상효과적상관성。방법제취89례복발성란소암환자혈양표본적DNA，학정UGT1A1화ERCC1기인형，연구UGT1A1기인다태성여이립체강인기적불량반응，ERCC1기인다태성대순박료효적상관성。결과 UGT1A1*28 WW휴대자，Ⅱ～Ⅳ도지발성성복사적발생솔위52.2％，WM+MM휴대자적발생솔위72.7％，OR（95%CI ）위2.1（1.6~9.2），량조비교차이유통계학의의（P=0.031）；UGT1A1*28 WW휴대자Ⅲ～Ⅳ도지발성성복사적발생솔위7.5％，WM+MM휴대자적발생솔위36.3%，량조비교P=0.000，OR（95%CI ）위4.9（3.3~15.8），차이유통계학의의（P=0.000）；ERCC1 WW휴대자，치료3개주기후적림상수익솔위30.3%，ERCC1 WM+MM휴대자적림상수익솔위20.2%，량조비교P=0.032，OR（95%CI）위3.2（1.4~9.1）。결론 UGT1A1*28시이립체강지발성복사적파기인，가증가이립체강발생엄중복사적풍험；ERCC1 WW기인대복발성란소암환자사용이립체강연합순박치료교휴대ERCC1 WM+MM기인환자능획득경호적림상효과。
Objective To study the genotype of UGT1A1 and ERCC1, and their relationship with the efficacy and toxicity of Irinotecan combined with Cisplatin for patients with advanced ovary cancer. Methods The allelic frequency of the UGT1A1 and ERCC1 mutant in a group of 89 advanced ovary cancer patients were determined. The relationship be-tween the adverse events of irinotecan-based chemotherapy and the efficacy of Cisplatin in patients with advanced ovary cancer were analyzed. Results For patients who carried the UGT1A1*28WW and UGT1A1*28WM+MM, the incidence of grade 2 or 3 tardiive diarrhea was 54.7%and 72.7%respectively, and the difference was statistically significant(P=0.031, OR=2.1, 95%CI:1.6~9.2). For grade 3 or4 tardive diarrhea, the incidence rate was 7.8%and 36.4%respectively in patients who carried UGT1A1*28WW and UGT1A1*28WM +MM,the difference was statistically significant (P= 0.000, OR=4.9, 95%CI:3.3~15.8). The response rate of ERCC1WW and ERCC1 WM+MM carriers was 30.3%and 20.2% respectively,the difference was significant (P=0.032, OR=3.2(95%CI):(1.4~9.1). Conclusion UGT1A1*28 is the target gene for tardive diarrhea, and UGT1A1*28 gene mutation increases the risk of diarrhea with irinotecan-based chemotherapy. ERCC1WW carriers can obtain better rate of clinical response than ERCC1 WM+MM carriers with Combined Irinotecan and Cisplatin Regimen.