本文選題：XPD基因多態(tài)性　切入點(diǎn)：晚期非小細(xì)胞肺癌　出處：《中國(guó)藥房》2016年24期 　論文類型：期刊論文

【摘要】：目的:系統(tǒng)評(píng)價(jià)晚期非小細(xì)胞肺癌(NSCLC)患者XPD Lys751Gln(A/C)和XPD Asp312Asn(G/A)多態(tài)性與以鉑類藥物為基礎(chǔ)的聯(lián)合化療臨床療效的相關(guān)性,為臨床提供循證參考。方法:計(jì)算機(jī)檢索Pub Med、Cochrane圖書館、EMBase、Medline、相關(guān)期刊論文、中文科技期刊數(shù)據(jù)庫(kù)和萬方數(shù)據(jù)庫(kù),收集有關(guān)NSCLC患者XPD Lys751Gln和XPD Asp312Asn多態(tài)性對(duì)以鉑類藥物為基礎(chǔ)的聯(lián)合化療的有效性、臨床結(jié)局和不良反應(yīng)影響的研究,采用Rev Man 5.3統(tǒng)計(jì)軟件進(jìn)行Meta分析。結(jié)果:共納入30項(xiàng)研究,合計(jì)5 028例患者�；驒z測(cè)結(jié)果發(fā)現(xiàn),XPD Lys751Gln分為變異型基因組(Lys/Gln+Gln/Gln)和野生型基因組(Lys/Lys),XPD Asp312Asn分為變異型基因組(Asp/Asn+Asn/Asn)和野生型基因組(Asp/Asp)。Meta分析結(jié)果顯示,XPD Lys751Gln多態(tài)性中攜帶變異型基因組患者的無疾病進(jìn)展生存期(PFS)明顯低于攜帶野生型基因組的患者[MD=-1.12,95%CI(-1.73,-0.50),P0.001],而化療有效性(TR)和總生存期(OS)比較差異無統(tǒng)計(jì)學(xué)意義。XPD Asp312Asn多態(tài)性中攜帶變異型基因組患者的TR顯著低于攜帶野生型基因組的患者[OR=0.80,95%CI(0.68,0.96),P=0.02],而PFS和OS比較差異均無統(tǒng)計(jì)學(xué)意義。安全性方面,XPD Lys751Gln多態(tài)性中攜帶變異型基因組患者的Ⅲ~Ⅳ級(jí)胃腸道不良反應(yīng)發(fā)生率顯著高于攜帶野生型基因組的患者[OR=0.43,95%CI(0.20,0.94),P=0.03),而Ⅲ~Ⅳ級(jí)血液系統(tǒng)不良反應(yīng)發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:XPD Lys751Gln多態(tài)性與晚期NSCLC患者以鉑類藥物為基礎(chǔ)的化療的PFS和Ⅲ~Ⅳ級(jí)胃腸道不良反應(yīng)有關(guān),而XPD Asp312Asn多態(tài)性與以鉑類藥物為基礎(chǔ)的化療的有效性有關(guān),兩個(gè)位點(diǎn)均可作為預(yù)測(cè)NSCLC患者采用以鉑類藥物為基礎(chǔ)的化療治療效果的考察靶點(diǎn)。
[Abstract]:Objective: to systematically evaluate the relationship between the polymorphism of XPD Lys751GlnntA / C) and XPD Asp312AsnA- G _ (-P _ (A)) in patients with advanced non-small cell lung cancer (NSCLC) and the clinical efficacy of platinum-based combined chemotherapy. Methods: the Pub Medsite Cochrane Library, the full text Database of Chinese Journals, the Chinese Sci-tech Journals Database and the Wanfang Database were searched by computer. The effects of XPD Lys751Gln and XPD Asp312Asn polymorphisms on the efficacy, clinical outcome and adverse reactions of platinum-based combination chemotherapy in patients with NSCLC were studied. Meta analysis was carried out with Rev Man 5.3 statistical software. Results: 30 studies were included. A total of 5 028 patients were enrolled in this study. The results of gene analysis showed that XPD Lys751Gln was divided into mutant genome Lys / Gln / Gln / Gln) and wild type genome Lys / Lysn / Asp312Asn into mutant genome AspP / Asn / AsnP / Asn. Meta-analysis of wild type Lys751Gln showed mutation in Lys751Gln polymorphism. The progression free survival time (PFSs) of patients with heterogeneous genomes was significantly lower than that of patients with wild type genomes [MD-1.12129CI-1.73CI-0.50P0.001], but there was no significant difference between the efficacy of chemotherapy and total survival time. XPD Asp312Asn polymorphism carried variant genomes. The tr of patients with wild genomes was significantly lower than that of patients with wild type genomes [ORX 0.80 / 9595], but there was no significant difference between PFS and OS. In terms of safety, adverse reactions of 鈪，

本文編號(hào)：1619131