XPC和XRCC1基因多态性与肝细胞癌根治术后预后的关联研究

摘要

Background and purpose:The literature suggests, XPC and XRCC1 gene polymorphisms were associated with tumors prognosis in recent years, but fewer studies have reported their association with liver cancer prognosis. This study aimed to investigate the association between single nucleotide polymorphism of XPC939, XRCC1-399 and prognosis of hepatocellular carcinoma (HCC) after radical resection. Methods:The blood of DNA and the data of clinical pathology, prognosis of survival of HCC patients who underwent radical resection and were hospitalized at Guangxi Medical University First Affiliated Hospital between Feb. 2007 and Oct. 2008 were analyzed, 143 cases with complete follow-up data were respectively analyzed. XPC939, XRCC1-399 genotypes were tested by TaqMan-MGB real-time fluorescence quantitative polymerase chain reaction (RT-PCR) technology. Kaplan-Meier method was used to analyze prognosis, log-rank test was used to compare between groups, and the Cox proportional hazards model was used for multivariate analysis. Results:The 1-, 2-and 3-year survival rates were 81.8%, 76.2%,67.1%, respectively. Median progression-free survival time was 27 months. Survival analysis showed that patients carrying allelic genotype of XPC939 C(AC+CC) had a longer median progression-free survival time (32 months) than the those carrying XPC939 A alleles (AA) genotype (16 months) (χ2=4.320, P<0.05). Tumor diameter stratified analysis showed that overall survival of patients carrying genotype of XRCC1-399 GG was higher than those carrying XRCC1-399 GA+AA genotype (χ2=4.105, P<0.05). Cox multivariate analysis did not show that XRCC1-399 was independently associated with HCC prognosis. Conclusion:Of all HCC patients after radical resection, there is no association between XPC939, XRCC1-399 polymorphism and clinical features, but XPC939 polymorphism is associated with progression-free survival and XRCC1-399 polymorphism may have a certain influence on the long-term prognosis of HCC patients after radical resection.%　　背景与目的：近几年的文献表明，XPC、XRCC1基因多态性与多种肿瘤预后生存相关，但其与肝癌预后关联研究的文献报道较少。本研究旨在探讨XPC939和XRCC1-399位点单核苷酸多态性与肝细胞癌(hepatocellular carcinoma，HCC)根治术后患者预后的关系。方法：收集2007年2月—2008年10月广西医科大学第一附属医院行肝癌根治性切除术，且经病理诊断为HCC的广西新发病例临床特征，血液DNA和预后生存资料，对其中143例有完整随访资料病例进行分析。采用TaqMan-MGB实时荧光定量聚合酶链式反应(real-time quantitative polymerase chain reaction，RT-PCR)技术对XPC939、XRCC1-399多态位点进行基因分型。应用Kaplan-Meier法进行生存分析，组间比较用Log-rank检验，多因素分析采用Cox模型分析。结果：总的1、2、3年生存率分别为81.8%、76.2%和67.1%，中位无进展生存时间为27个月。生存分析显示，携带XPC939 C等位基因基因型AC+CC患者中位无进展生存时间(32个月)长于携带XPC939 A等位基因(AA)基因型患者(16个月)，差异有统计学意义(χ2=4.320，P<0.05)。按肿瘤直径大小分层分析显示，携带XRCC1-399 GG基因型患者的总体生存率高于携带XRCC1-399 GA+AA基因型患者，差异有统计学意义(χ2=4.105，P<0.05)。多因素Cox回归分析未发现XRCC1-399基因与HCC根治术后患者预后独立相关。结论：在行HCC根治术后的患者预后中，XPC939和XRCC1-399基因多态性与临床特征无关，XPC939基因多态性与无进展生存期相关，XRCC1-399基因多态性可能对HCC根治术后患者远期预后有一定影响。