摘要
目的分析范可尼贫血互补群D2(fanconi anemia complementation group D2,FANCD2)突变与卵巢上皮癌(epithelial ovarian cancer,EOC)患者行新辅助化疗(neoadjuvant chemotherapy,NACT)后的疗效及预后的相关性。方法选取2017年4月至2019年4月兵器工业五二一医院收治的184例EOC患者为研究对象,取穿刺活检组织并提取DNA,采用实时荧光定量PCR检测患者FANCD2基因的突变情况,分析FANCD2基因突变与EOC患者临床病理参数的相关性;进一步分析FANCD2突变与NACT治疗4周后的疗效及预后的关系。结果实时荧光定量PCR结果表明,FANCD2基因突变率为42.39%。FANCD2突变型与野生型EOC患者的肿瘤病灶直径、ECOG评分、分化程度和病理分型比较的差异具有统计学意义(P值分别为0.024,0.037,<0.001,0.002)。FANCD2突变型EOC患者的疾病控制率(disease control rate,DCR)显著低于FANCD2野生型EOC患者(66.67%vs 83.96%,χ^(2)=7.506,P=0.006)。184例EOC患者的总体生存率为65.22%,FANCD2突变型EOC患者的2年生存率显著低于FANCD2野生型(32.07%vs 42.31%,log rankχ2=4.152,P=0.042)。Cox风险比例模型多因素显示,分化程度和病理分型是FANCD2突变的独立影响因素(P<0.05)。运用Kaplan-Meier法对患者进行单因素生存分析发现,肿瘤大小(P=0.031)、肿瘤病理分型(P<0.001)、分化程度(P<0.001)、突变型FANCD2的表达(P=0.042)与患者的总生存期密切相关。Cox风险比例模型多因素分析显示,肿瘤病理分型、分化程度和FANCD2突变是EOC患者预后的独立影响因素(P值分别为0.014,0.035,0.036)。结论FANCD2基因突变与EOC患者NACT疗效相关,肿瘤病理分型、分化程度、FANCD2突变是EOC患者预后的独立影响因素。
Objective To investigate the correlation of fanconi anemia complementation group D2(FANCD2)mutation with efficacy and prognosis of neoadjuvant chemotherapy(NACT)in patients with epithelial ovarian cancer(EOC).Methods A total of 184 EOC patients admitted in 521 Hospital of Norinco Group during April 2017 and April 2019 were selected.Their biopsy tissues were taken,and DNA was extracted.The mutation of FANCD2 gene was detected by real-time fluorescent quantitative PCR,and its correlation with the clinicopathological parameters of EOC patients was analyzed.The relationship between FANCD2 mutation and the efficacy and prognosis after 4 weeks of NACT treatment was also analyzed.Results The real-time fluorescent quantitative PCR showed that the mutation rate of FANCD2 gene was 42.39%.There were significant differences in tumor lesion diameter,Eastern Cooperative Oncology Group(ECOG)score,degree of differentiation and pathological classification between mutant and wild-type FANCD2 of patients with EOC(P=0.024,0.037,<0.001 and 0.002,respectively).The disease control rate(DCR)of EOC patients with mutant FANCD2 gene was significantly lower than that with wild-type FANCD2(66.67%vs 83.96%,χ^(2)=7.506,P=0.006).The overall survival rate of 184 EOC patients was 65.22%,and the 2-year survival rate of EOC patients with mutant FANCD2 gene was significantly lower than that with wild-type FANCD2(32.07%vs 42.31%,log rankχ2=4.152,P=0.042).Multivariate Cox regression model analysis showed that the degree of differentiation and pathological classification were independent factors of FANCD2 gene mutation(P<0.05).The univariate survival analysis of patients by the Kaplan-Meier method showed that tumor size(P=0.031),tumor pathological classification(P<0.001),degree of differentiation(P<0.001)and expression of mutant FANCD2(P=0.042)were closely related to the overall survival of EOC patients.Multivariate Cox proportional-hazards model analysis showed that tumor pathological classification,degree of differentiation and FANCD2 mutation were independent factors affecting the prognosis of EOC patients(P=0.014,0.035 and 0.036,respectively).Conclusion The mutation of FANCD2 gene is associated with the efficacy of NACT in EOC patients,and tumor pathological classification,degree of differentiation and FANCD2 mutation are independent factors affecting the prognosis of EOC patients.
作者
朱娇
王英英
刘娟
李新红
刘素荣
刘静静
ZHU Jiao;WANG Yingying;LIU Juan;LI Xinhong;LIU Surong;LIU Jingjing(Department of Oncology and Hematology,521 Hospital of Norinco Group,Xi′an 710065,Shaanxi;The Second Department of Oncology,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China)
出处
《临床检验杂志》
CAS
2022年第9期678-681,共4页
Chinese Journal of Clinical Laboratory Science
关键词
范可尼贫血互补群D2
基因突变
卵巢上皮癌
新辅助化疗
预后
fanconi anemia complementation group D2
gene mutation
epithelial ovarian cancer
neoadjuvant chemotherapy
prognosis
作者简介
朱娇,1987年生,女,主治医师,硕士,研究方向为肿瘤血液病诊断;通信作者:王英英,硕士,E-mail:wyylyf555@163.com。
