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目的:探讨放化疗作用相关通路基因多态性与初治局部区域晚期鼻咽癌患者预后的关系。方法:入组203例局部区域晚期鼻咽癌患者。检测属于放化疗通路或顺铂/氟尿嘧啶通路的13个基因、18个位点的单核苷酸多态性(SNP),采用Kaplan-Meier法进行生存分析,Cox回归进行多因素分析。结果:Kaplan-Meier分析显示,携带rs25487AA、rs1136410CC+TT基因型的患者总生存率降低;携带rs2032582AT基因型的患者无局部区域复发生存率降低;携带rs25487AA、rs2010963CC、rs833061CT+TT基因型的患者无远处转移生存率降低;携带rs3212986GG、rs25487AA、rs2032582AT、rs2279744GG+GT基因型的患者无进展生存率降低。Cox分析显示,上述位点除rs833061CT+TT基因型外,均为预后的独立危险因素(P<0.05)。结论:放化疗作用相关通路中的多个SNP是影响局部区域晚期鼻咽癌的独立预后因素,为鼻咽癌的个体化治疗和判断预后提供了参考指标。
Objective: To investigate the relationship between chemopreventive pathway-related gene polymorphism and the prognosis of locally advanced nasopharyngeal carcinoma patients. Methods: 203 cases of advanced nasopharyngeal carcinoma in the local area were enrolled. Single nucleotide polymorphisms (SNPs) of 13 genes and 18 loci belonging to the chemoradiation or cisplatin / fluorouracil pathway were detected by Kaplan-Meier method. Cox regression was used for multivariate analysis. Results: Kaplan-Meier analysis showed that the overall survival rate of patients with rs25487AA and rs1136410CC + TT genotypes was lower than those without rs2032582AT genotype. No recurrence-free survival rate was found in the patients with rs2032582AT genotype. The patients with rs25487AA, rs2010963CC and rs833061CT + TT genotype had no Distant metastasis survival rate decreased; patients carrying rs3212986GG, rs25487AA, rs2032582AT, rs2279744GG + GT patients with progression-free survival decreased. Cox analysis showed that the above sites were independent prognostic risk factors except rs833061CT + TT genotype (P <0.05). CONCLUSIONS: Multiple SNPs in the pathways associated with chemoradiotherapy are independent prognostic factors influencing advanced nasopharyngeal carcinoma in the local area and provide a reference index for individualized treatment and prognosis of NPC.