UGT1A1基因多肽性与伊立替康联合雷替曲塞治疗晚期结直肠癌的临床分析.docxVIP

UGT1A1基因多肽性与伊立替康联合雷替曲塞治疗晚期结直肠癌的临床分析 　　[摘要] 目的 研究尿苷二磷酸葡糖苷酸?D移酶1A1基因多态性与伊立替康联合雷替曲塞化疗方案治疗晚期结直肠癌的疗效及不良反应相关性。 方法 方便选取XX年5月―XX年10月于江苏大学附属武进人民医院肿瘤内科接受伊立替康联合雷替曲塞治疗的晚期结直肠癌患者60例，提取外周血中基因组DNA，PCR法扩增UGT1A1*6和UGT1A1*28基因的相应片段，双向测序法分析PCR产物，检测患者UGT1A1*6和UGT1A1*28基因型，分析UGT1A1基因多态性情况，并对给予伊立替康联合雷替曲塞化疗方案治疗的结直肠癌患者进行随访，记录疗效以及不良反应情况。 结果 60例结直肠癌患者化疗后完全缓解0例，部分缓解11例，稳定22例，进展27例，有效率为%；中位疾病进展时间为个月；中位生存期为个月。疗程中出现的主要不良反应包括中性粒细胞减少、迟发性腹泻、转氨酶异常、血小板减少、疲劳及食欲下降等，分别占%、%、%、%、%，多为I～II级；但UGT1A1*28基因型显著增加发生III级以上中性粒细胞减少的风险，并增加整体不良反应发生率。 结论 伊立替康联合雷替曲塞是治疗晚期结直肠癌有效方案，UGT1A1*28位点可预测伊立替康引起的不良反应，便于个体化治疗。　　[关键词] UGT1A1；伊立替康；雷替曲塞；基因多态性；结直肠癌　　[中图分类号] R735 [文献标识码] A [文章编号] 1674--0040-04　　[Abstract] Objective This paper tries to study the correlation between the polymorphism of uridine two phosphate glucuronosyltransferase 1A1 gene and irinotecan combined with reetrexed chemotherapy in the treatment of advanced colorectal cancer. Methods 60 cases of colorectal cancer patients from May XX to October XX in this hospital received irinotecan combined with pemetrexed for the treatment of thunder advanced colon were convenient selected and were extracted from peripheral blood genomic DNA， amplification of the corresponding fragment UGT1A1*6 and UGT1A1*28 gene PCR analysis method， PCR products sequencing method， the detection of patients with UGT1A1*6 and UGT1A1*28 gene type analysis of UGT1A1 gene polymorphism， and given irinotecan plus raltitrexed chemotherapy in the treatment of patients with colorectal cancer were followed up to record the efficacy and adverse reactions. Results 60 cases of colorectal cancer patients after chemotherapy， complete remission in 0 cases， partial remission in 11 cases， stable in 22 cases， progress in 27 cases， the effective rate was %， the median time to progression was months， and the median survival time was months. The main adverse reactions appeared in the course of treatment included neutropenia and delayed diarrhea， abnormal transaminase， thrombocytopenia， fatigue and loss