CAJ | 학술논문

目的：观察肺腺癌患者亚甲基四氢叶酸还原酶（MTHFR）基因C677T多态性与化疗疗效的关系。方法化疗前抽取92例肺腺癌患者外周血液，用聚合酶链式反应-限制性片断长度多态性（PCR-RFLP）方法检测MTHFR基因C677T多态性，并分析其与化疗的疗效关系。结果92例肺腺癌患者中，MTHFR基因C677T野生型（CC）的分布为60.9%（56/92），纯合突变型（TT）为14.1%（13/92），杂合突变型（CT）为25.0%（23/92）。一线化疗方案使用培美曲塞/卡铂的疗效：野生型（CC）PR 20例，SD 19例，PD 17例，总有效率（ORR）为35.7%；纯合突变型（TT）PR 2例，SD 7例， PD 4例，ORR为15.4%；杂合突变型（CT）SD 13例，PD 10例，ORR为0。CC型患者化疗ORR显著高于TT型和CT型者（P=0.001）。CC型与TT型/CT型患者的肿瘤进展时间（TTP）分别为6.2个月和4.7个月，差异有统计学意义（P=0.023）。二线化疗方案使用吉西他滨/奈达铂或多西紫杉醇/奈达铂的疗效：CC型PR 2例，SD 5例，PD 10例；TT型SD 3例；CT型PR 1例，SD 2例，PD 7例，CC型与TT型/CT型患者的ORR比较，差异无统计学意义（P=1.000）。结论 MTHFR基因C677T野生型（CC）肺腺癌患者可能是使用培美曲塞联合卡铂化疗有效的人群。MTHFR基因C677T CC型患者的TTP显著长于TT型患者和CT型患者。MTHFR基因C677T多态性与吉西他滨/奈达铂或多西紫杉醇/奈达铂化疗疗效无关。
목적：관찰폐선암환자아갑기사경협산환원매（MTHFR）기인C677T다태성여화료료효적관계。방법화료전추취92례폐선암환자외주혈액，용취합매련식반응-한제성편단장도다태성（PCR-RFLP）방법검측MTHFR기인C677T다태성，병분석기여화료적료효관계。결과92례폐선암환자중，MTHFR기인C677T야생형（CC）적분포위60.9%（56/92），순합돌변형（TT）위14.1%（13/92），잡합돌변형（CT）위25.0%（23/92）。일선화료방안사용배미곡새/잡박적료효：야생형（CC）PR 20례，SD 19례，PD 17례，총유효솔（ORR）위35.7%；순합돌변형（TT）PR 2례，SD 7례， PD 4례，ORR위15.4%；잡합돌변형（CT）SD 13례，PD 10례，ORR위0。CC형환자화료ORR현저고우TT형화CT형자（P=0.001）。CC형여TT형/CT형환자적종류진전시간（TTP）분별위6.2개월화4.7개월，차이유통계학의의（P=0.023）。이선화료방안사용길서타빈/내체박혹다서자삼순/내체박적료효：CC형PR 2례，SD 5례，PD 10례；TT형SD 3례；CT형PR 1례，SD 2례，PD 7례，CC형여TT형/CT형환자적ORR비교，차이무통계학의의（P=1.000）。결론 MTHFR기인C677T야생형（CC）폐선암환자가능시사용배미곡새연합잡박화료유효적인군。MTHFR기인C677T CC형환자적TTP현저장우TT형환자화CT형환자。MTHFR기인C677T다태성여길서타빈/내체박혹다서자삼순/내체박화료료효무관。
Objective To investigate a possible correlation between C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR)gene and chemotherapy efficacy in patients with pulmonary adenocarcinoma. Methods Peripheral blood samples from 92 p atients with pulmonary adenocarcinoma were collected before chemotherapy,and the C677T polymorphism was genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).We examined whether genotype correlated with whether the patients showed partial response(PR),stable disease(SD)or progressive disease(PD)following chemotherapy. Results Of the 92 patients,56 (60.9%) had wild-type genotype (CC),13(14.1%) were homozygous mutant(TT),and 23(25.0%) were heterozygous mutant(CT).Among the patients treated with pemetrexed/carpoplatin as first-line regimen,CC patients showed an overall response rate (ORR)of 35.7%,with 20 CC patients achieving PR;19,SD;and 17,PD.Among TT patients,ORR was 15.4%,with 2 patients achieving PR;7,SD;and 4,PD.Among CT patients,ORR was 0,with 13 achieving SD and 10,PD.ORR was significantly higher in CC patients than in TT or CT patients (P=0.001).In addition,CC patients showed significantly longer time to progression (6.2 months)than did TT or CT patients (4.7 months;P=0.023).Among the patients treated with gemcitabine/nedaplatin or docetaxel/nedaplatin as second-line regimen,2 CC patients showed PR;5,SD;and 10,PD.3 TT patients achieved SD;among CT patients, 1 achieved PR,2 SD and 7,PD.ORR was similar between CC and TT/CT patients (P=1.000). Conclusions Pemetrexed in combination with carboplatin may be associated with greater therapeutic efficacy and longer time to progression in CC patients than in TT/C T patients.However,genotype at the MTHFR C677T polymorphism does not appear to influence the therapeutic efficacy of gemcitabine/nedaplatin or docetaxel/nedaplatin.