切除修复交叉互补基因1、核糖核苷酸还原酶M1亚基和3型β微管蛋白分子检测指导晚期非小细胞肺癌个体化治疗的临床效果.docVIP

切除修复交叉互补基因1、核糖核苷酸还原酶M1亚基和3型β微管蛋白分子检测指导晚期非小细胞肺癌个体化治疗的临床效果 　　[摘要] 目的 探讨切除修复交叉互补基因1（ERCC1）、核糖核苷酸还原酶M1亚基（RRM1）和3型β微管蛋白（TUBB3）分子检测在指导晚期非小细胞肺癌（NSCLC）个体化治疗的临床效果。 方法 将2013年1～11月秦皇岛市第二医院胸外科住院治疗的48例经病理确诊的晚期NSCLC患者分为实验组（20例）和对照组（28例）。实验组采用SYBR荧光实时定量PCR检测方法检测患者胸水或静脉血中ERCC1、RRM1和TUBB3的表达量，根据表达情况选择化疗方案；对照组则均采用顺铂与吉西他滨联合治疗。经过2个周期治疗后比较两组的疗效、不良反应及疾病进展、生存获益情况。 结果 实验组的总有效率和总控制率均显著高于对照组（P 0.05）；两组间不良反应发生率差异无统计学意义（P 0.05），且两组间不同系统的不良反应严重程度差异均无统计学意义（P 0.05）。 结论 实时定量PCR技术检测病理组织的ERCC1、RRM1和TUBB3表达水平用于指导晚期NSCLC患者个体化治疗，可提高治疗有效率和疾病控制率，但在改善生活质量和减少不良反应发生效果不显著，建议进一步探索标志物指导下更为有效的化疗方案。 　　[关键词] 切除修复交叉互补基因1；核糖核苷酸还原酶M1亚基；3型β微管蛋白；非小细胞肺癌；化疗 　　[中图分类号] R734.2 [文献标识码] A [文章编号] 1673-7210（2016）01（b）-0081-04 　　[Abstract] Objective To explore the clinical effect of excision repair cross complementary1 （ERCC1）， ribonucleofide reductase large subunit 1（RRM1） and tubulin β 3 （TUBB3） molecular detection guiding advanced non-small-cell carcinoma （NSCLC） individualized treatment. Methods From January to November 2013， in the Second Hospital of Qinhuangdao City， 48 patients with pathologically diagnosed advanced NSCLC were selected and divided into experiment group （20 cases） and control group （28 cases）. The experiment group were given SYBR real-time PCR testing methods to detect expression levels of ERCC1， RRM1 and TUBB3 with pleural fluid or blood， according to the expression results， the chemotherapy scheme was chosen； the control group were given combination therapy with Cisplatin and Gemcitabine. The efficacy， toxicity and disease progression， survival benefit situation after two treatment cycles of two groups were compared. Results The total efficiency and total control rate in the experiment group were significantly higher than those in the control group （P 0.05）； the incidence of adverse reactions in two groups was compared， the difference was not statistically significant （P 0.05）， and the severity of adverse reactions of different systems in two groups were compared， the differences were not s