Objective:To investigate the association between p53 codon 72 polymorphism and the prognosis of breast cancer pa-tients receiving chemotherapy and radiotherapy after surgery. Methods:A total of 427 breast cancer patients treated with chemo-radio-therapy after surgery at Beijing Cancer Hospital were selected for this study. Polymerase chain reaction–restriction fragment length polymorphism was adopted to analyze the p53 codon 72 polymorphism. Survival analysis was conducted to compare the disparities of recurrence and survival among the patients with different p53 codon 72 polymorphic variants. Results:The distribution of three geno-types of p53 codon 72 in our cohort is as follows:Pro/Pro 18.3%(78/427), Pro/Arg 44.0%(188/427), and Arg/Arg 37.7%(161/427). No significant difference was observed among the local recurrence-free survival (LRFS), loco-regional recurrence-free survival (LR-RFS), distant disease-free survival (DDFS), and overall survival (OS) among the three genotypes (all P>0.05). Among the 303 estro-gen receptor (ER)-positive patients, OS was significantly better in patients with Arg/Arg genotype than those with Pro/Pro genotype (χ2=6.33, P=0.042). The multivariate analysis showed that the p53 codon 72 polymorphism is an independent factor of prognosis for LRFS, LRRFS, DDFS, and OS of ER-positive patients. For the ER positive patients with Pro/Pro genotype, the local recurrence, local-regional recurrence, distant metastasis, and mortality risks were 5.9 (HR=5.9, 95%CI 1.1-31.1, P=0.036), 3.1 (HR = 3.1, 95% CI 1.1-9.1, P=0.039), 2.8 (HR=2.8, 95% CI 1.3-6.0, P=0.010), and 4.0 (HR=4.0, 95% CI 1.3-12.0, P=0.013) times higher than those with Arg/Arg genotype, respectively. Conclusion:For ER-positive breast cancer patients who underwent surgery and chemo-radiotherapy, the local recurrence, loco-regional recurrence, distant metastasis, and mortality risk with Pro/Pro genotype are significantly higher compared to those with Arg/Arg genotype.%目的:分析p53基因codon 72多态性与乳腺癌患者术后放化疗的预后相关性。方法:选取北京大学肿瘤医院乳腺癌患者术后接受放化疗427例,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法分析其p53基因codon 72多态性,比较不同基因型患者间复发及生存的差异。结果:全部患者基因型分布为Pro/Pro型18.3%(78/427)、Pro/Arg型44.0%(188/427)、Arg/Arg型37.7%(161/427)。3种基因型间无局部复发生存(LRFS)、无局部区域复发生存(LRRFS)、无远处转移生存(DDFS)及总生存(OS)均无显著性差异(均P>0.05)。427例患者中雌激素受体(ER)阳性为303例,其中Arg/Arg基因型患者OS明显优于Pro/Pro基因型患者(χ2=6.330,P=0.042)。在多因素分析中p53基因codon 72多态性是ER阳性患者LRFS、LRRFS、DDFS及OS的独立预后因素,Pro/Pro基因型的患者较Arg/Arg基因型的局部复发风险增加5.9倍(HR=5.9,95%CI 1.1~31.1,P=0.036),局部区域复发风险增加3.1倍(HR=3.1,95%CI 1.1~9.1,P=0.039),远处转移风险增加2.8倍(HR=2.8,95%CI 1.3~6.0,P=0.010),死亡风险增加4倍(HR=4.0,95%CI 1.3~12.0,P=0.013)。结论:在ER阳性的乳腺癌术后接受放化疗患者中,Pro/Pro基因型的局部及局部区域复发风险、远处转移风险、死亡风险均高于Arg/Arg基因型。
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