基因检测在指导非小细胞肺癌化疗中的作用

摘要

目的：探讨非小细胞肺癌相关基因检测在指导其化疗中的作用。方法选取2013年1月—2015年3月天津市人民医院收治的非小细胞肺癌患者60例作为研究对象。采用简单随机抽样法将患者分为观察组和对照组，各30例。观察组患者使用免疫组化法对分子标志物核苷酸切除修复交叉互补基因1和核苷酸还原酶亚单位M1进行检测，根据这两种分子标志物表达情况指导患者化疗方案；对照组患者采用顺铂联合多西他赛或者顺铂联合吉西他滨进行化疗。观察两组患者化疗总有效率、生存期、无进展生存期及毒副作用。结果观察组患者化疗总有效率为56.7％（17／30），高于对照组的30.0％（9／30）（χ2＝6.278， P＝0.043）。观察组患者中位生存期为252 d，高于对照组的225 d （χ2＝6.327， P ＝0.031）；观察组患者中位无进展生存期为172 d，高于对照组的128 d （χ2＝6.651， P＝0.023）。两组患者肝肾功能异常、胃肠道反应、血液毒性发生率比较，差异无统计学意义（ P＞0.05）。结论核苷酸切除修复交叉互补基因1以及核苷酸还原酶亚单位M1的表达情况与非小细胞肺癌选择化疗疗效有密切联系，有可能成为指导非小细胞肺癌选择化疗方案、预测化疗疗效的重要指标。%Objective To explore the effect of gene detection related with non-small cell lung cancer on the guidance of chemotherapy.Methods A total of 60 patients with non-small cell lung cancer in Tianjin People Hospital from January 2013 to March 2015 were enrolled.The patients were divided into observation group and control group with 30 patients in each group according to the simple random sampling.Nucleotide excision repair cross complementation gene 1 and nucleotide reductase subunit M1 of patients in observation group were detected by immunohistochemistry.Chemotherapy regimens were made according to the expression of the two molecular markers.Patients in control group was cured by cis-platinum combined with docetaxel or gemcitabine.The total effective rate, survival time, progress -free survival and toxic and side effect of the two groups were observed.Results The total effective rate of chemotherapy in the observation group 〔56.7% (17/30)〕 was higher than that in control group 〔30.0% ( 9/30 )〕 (χ2 =6.278, P =0.043 ) .The median survival time of patients in observation group (252 d) was higher than that in control group (225 d) (χ2 =6.327, P=0.031); the median progress-free survival of patients in observation group (172 d) was higher than that in control group (128 d) (χ2 =6.651, P=0.023) .The abnormity of hepatic and renal function, gastrointestinal reaction, the occurrence rate of hematotoxicity between the two groups were not significantly different ( P>0.05) .Conclusion The expression levels of nucleotide excision repair cross complementation gene 1 and nucleotide reductase subunit M1 are closely related with the result of chemotherapy of non-small-cell lung cancer and may become important indexes for the guidance of the chemotherapy.