MTHFR C677T基因型与结直肠癌患者化疗消化道不良反应的关系分析
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摘要
目的研究结直肠癌患者亚甲基四氢叶酸还原酶(MTHFR) C677T2015年8月至2017年8月本院80例接受6周期FOLFOX4化疗的结直肠癌患者作为研究对象,分析不同MTHFR C677T基因型与化疗消化道不良反应的关系。结果 80例患者中MTHFR C677T C/C型23例(28.75%),T/T型35例(43.75%),T/C型22例(27.50%),共58例患者发生消化道不良反应。不同基因型患者的消化道不良反应发生率比较,差异有统计学意义(P <0.05),其中C/C型、T/T型、T/C型不良反应发生率分别为52.17%与不同严重程度的消化道不良反应发生情况有关(P <0.05),其中C/C型、T/T型、T/C型组Ⅱ度以上不良反应发生例数分别为8例、28例及2例。结论不同MTHFR C677T基因型结直肠癌患者化疗消化道不良反应发生率及严重程度有差异,其可为临床评估提供一定参考。
Objectives To study the relationship between digestive tract adverse reactions and methylenetetrahydrofolate reductase(MTHFR) C677 T genotypes in colorectal cancer patients caused by chemotherapy. Methods Eighty patients with colorectal cancer who received six cycles of FOLFOX4 chemotherapy from August 2015 to August 2017 were enrolled in this study. The relationship between MTHFR C677 T genotypes and digestive tract adverse reactions caused by chemotherapy was analyzed. Results Among the 80 patients, 23(28.75%) had MTHFR C677 T C/C genotype, 35(43.75%) T/T genotype and 22(27.50%) T/C genotype. A total of 58 patients had digestive tract adverse reactions. The incidence of digestive tract adverse reactions in patients with different genotypes was significantly different(P < 0.05). The incidence of adverse reactions of MTHFR C677 T C/C genotype,T/T genotype and T/C genotype were 52.17%(12/23), 91.43%(32/35) and 63.64%(14/22), respectively. The genotypes of MTHFR C677 T was associated with the occurrence of digestive tract adverse reactions of different severity(P < 0.05). Among them, 8 cases, 28 cases and 2 cases of MTHFR C677 T C/C genotype, T/T genotype and T/C genotype had more serious than degree II adverse reactions respectively. Conclusion The incidence and severity of digestive tract adverse reactions caused by chemotherapy in patients with different MTHFR C677 T genotypes of colorectal cancer are different, which may provide a reference for clinical evaluation.
Objectives To study the relationship between digestive tract adverse reactions and methylenetetrahydrofolate reductase(MTHFR) C677 T genotypes in colorectal cancer patients caused by chemotherapy. Methods Eighty patients with colorectal cancer who received six cycles of FOLFOX4 chemotherapy from August 2015 to August 2017 were enrolled in this study. The relationship between MTHFR C677 T genotypes and digestive tract adverse reactions caused by chemotherapy was analyzed. Results Among the 80 patients, 23(28.75%) had MTHFR C677 T C/C genotype, 35(43.75%) T/T genotype and 22(27.50%) T/C genotype. A total of 58 patients had digestive tract adverse reactions. The incidence of digestive tract adverse reactions in patients with different genotypes was significantly different(P < 0.05). The incidence of adverse reactions of MTHFR C677 T C/C genotype,T/T genotype and T/C genotype were 52.17%(12/23), 91.43%(32/35) and 63.64%(14/22), respectively. The genotypes of MTHFR C677 T was associated with the occurrence of digestive tract adverse reactions of different severity(P < 0.05). Among them, 8 cases, 28 cases and 2 cases of MTHFR C677 T C/C genotype, T/T genotype and T/C genotype had more serious than degree II adverse reactions respectively. Conclusion The incidence and severity of digestive tract adverse reactions caused by chemotherapy in patients with different MTHFR C677 T genotypes of colorectal cancer are different, which may provide a reference for clinical evaluation.
引文
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[11]李婧,潘玉春,李亦学,等.人类基因组单核苷酸多态性和单体型的分析及应用[J].遗传学报,2005,32(8):879-889.
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[14]张建功,郝长付,别荣海.5,10-亚甲基四氢叶酸还原酶C677T基因多态性与结直肠癌易感性关系的Meta分析[J].现代预防医学,2013,40(16):2982-2986.
[2]张宏伟.替吉奥联合奥沙利铂对比FOLFOX4方案治疗晚期结直肠癌的临床研究[J].中国临床药理学杂志,2013,29(8):584-586.
[3]KANTERMAN J,SADE-FELDMAN M,BITON M,et al.Adverse immunoregulatory effects of 5FU and CPT11 chemotherapy on myeloid-derived suppressor cells and colorectal cancer outcomes[J].Cancer Research,2014,74(21):6022.
[4]SHIAO S P,YU C H.Meta-prediction of MTHFR gene polymorphism mutations and associated risk for colorectal cancer[J].Biological Research for Nursing,2016,18(4):357.
[5]EDGE S B,BYRD D R,COMPTON C C,et al.AJCC cancer staging manual[M].7thed.New York:Springer,2010.
[6]崔琮,靳杨,谭招丽,等.结直肠癌患者血清外泌体代替肿瘤组织检测K-Ras基因突变的研究[J].临床肿瘤学杂志,2017,22(5):395-399.
[7]MILLER A B,HOOGSTRATEN B,STAQUET M,et al.Reporting results of cancer treatment[J].Cancer,1981,47(1):207-214.
[8]BENSON A B,BEKAIISAAB T,CHAN E,et al.Metastatic colon cancer,version 3.2013:featured updates to the NCCNGuidelines[J].J Natl Compr Canc Netw,2013,11(2):141-152.
[9]李国强,罗敬,郑志坚,等.局部晚期直肠癌术前新辅助放化疗的临床效果观察[J].结直肠肛门外科,2017,23(3):345-348.
[10]王全玉,何炜,蔺强,等.中药联合化疗治疗晚期结肠癌的临床疗效观察[J].现代消化及介入诊疗,2015,20(4):387-389.
[11]李婧,潘玉春,李亦学,等.人类基因组单核苷酸多态性和单体型的分析及应用[J].遗传学报,2005,32(8):879-889.
[12]DANTONIO C,MILANO A,RIGHINI R,et al.Pharmacogenomics in lung cancer chemotherapy:a review of what the oncologist should know[J].Anticancer Research,2014,34(10):5241-5250.
[13]白羽,吴海伟,刘颖,等.二氢嘧啶脱氢酶和亚甲基四氢叶酸还原酶基因多态性与卡培他滨方案治疗结直肠癌患者药物不良反应的相关性[J].中国临床药理学杂志,2017,33(17):1637-1640.
[14]张建功,郝长付,别荣海.5,10-亚甲基四氢叶酸还原酶C677T基因多态性与结直肠癌易感性关系的Meta分析[J].现代预防医学,2013,40(16):2982-2986.