摘要
目的探讨切除修复交叉互补基因⁃1(ERCC1)、乳腺癌基因⁃1(BRCA1)及Bcl⁃2结合抗凋亡基因1(BAG⁃1)检测在晚期非小细胞肺癌(NSCLC)患者铂类化疗敏感性、预后评估中的应用价值。方法选取2018年3月至2019年5月本院收治的80例晚期(Ⅲ期和Ⅳ期)NSCLC患者作为观察组。观察组经过铂类药物化疗后,分析化疗结果,分析三项指标基因多态性与铂类药物过敏性的关联性。随访2年,记录患者预后情况。绘制ROC分析联合三项指标检测对患者预后的预测价值。结果80例NSCLC患者治疗4周后,完全缓解(CR)1例(1.25%),部分缓解(PR)27例(33.75%),稳定(SD)33例(41.25%),进展(PD)19例(23.75%),总有效率为35.00%(28/80)。ERCC1、BRCA1及BAG⁃1位点CC、CT、TT基因型化疗疗效比较差异具有统计学意义(P<0.05)。80例晚期NSCLC患者2年生存率为22.50%(18/80)。ERCC1及BAG⁃1异常升高、BRCA1异常降低的晚期NSCLC患者死亡率更高(P<0.05)。ROC结果显示三者联合预测预后灵敏度、特异度、AUC分别为90.70%、92.50%、0.994,显著高于各指标单一检测(P<0.05)。结论ERCC1、BRCA1及BAG⁃1与晚期NSCLC化疗敏感性、预后相关,联合三者检测有助于临床为患者制定个体化治疗方案,以改善患者预后。
Objective To explore the application value of excision repair cross complementation group 1(ERCC1),breast cancer susceptibility gene 1(BRCA1),and Bcl⁃2 associated athanogene 1(BAG⁃1)detection in the evaluation of platinum⁃based chemotherapy sensitivity and prognosis of patients with advanced nonsmall⁃cell lung cancer(NSCLC).Methods 80 patients with advanced NSCLC(stage III and IV)admit⁃ted to this hospital from March 2018 to May 2019 were selected as the observation group.After platinum⁃based chemotherapy in patients with advanced NSCLC,the results of chemotherapy were analyzed,and the correla⁃tion between the gene polymorphisms of the three indicators and platinum⁃based drug allergy was analyzed.The patients were followed up for 2 years and the prognosis of the patients was recorded.The ROC was drawn to analyze the predictive value of the combined detection of three indicators for the prognosis of pa⁃tients.Results After 4 weeks of treatment in 80 patients with NSCLC,1 case had a complete remission(CR)(1.25%),a partial remission(PR)27 cases(33.75%),a stable(SD)33 cases(41.25%),and a pro⁃gressive(PD)19 cases(23.75%),the total effective rate is 35.00%(28/80).There was a statistically signifi⁃cant difference in the efficacy of ERCC1,BRCA1 and BAG⁃1 sites CC,CT,TT genotype chemotherapy(P<0.05).The 2⁃year survival rate of 80 patients with advanced NSCLC was 22.50%(18/80).The mortality of advanced NSCLC patients with abnormally elevated ERCC1 and BAG⁃1 and abnormally decreased BRCA1 was higher,and the difference was statistically significant(P<0.05).ROC results showed that the sensitivity and specificity of the combined examination in predicting prognosis were 90.70 and 92.50,respectively,which were significantly higher than those of ERCC1,BRCA1 and BAG⁃1 single examination(P<0.05).Conclu⁃sion ERCC1,BRCA1,and BAG⁃1 are related to the sensitivity and prognosis of advanced NSCLC chemo⁃therapy.The combined detection of the three can help clinically develop individualized treatment plans for pa⁃tients to improve patient prognosis.
作者
刘祺
周政涛
冯正富
聂琬吁
LIU Qi;ZHOU Zhengtao;FENG Zhengfu;NIE Wanyu(Qingyuan People's Hospital,The Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan,Guangdong,China,511518)
出处
《分子诊断与治疗杂志》
2021年第8期1243-1246,1250,共5页
Journal of Molecular Diagnostics and Therapy
基金
清远市科技计划项目(180524111900159)。
