摘要
目的探讨O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)甲基化状态对脑胶质瘤病人术后替莫唑胺(TMZ)化疗敏感性的影响。方法选取2022年1-12月沧州市中心医院收治的60例脑胶质瘤病人为研究对象,所有病人均进行显微手术治疗,并均在术后辅以TMZ化疗。根据MGMT甲基化状态检测结果将病人分为甲基化阳性组(31例)和甲基化阴性组(29例),根据化疗效果将病人分为化疗有效组(38例)和化疗无效组(22例)。比较甲基化阳性与阴性组的化疗效果,并对TMZ化疗敏感性的影响因素进行单因素分析和多因素Logistic回归模型分析。结果甲基化阳性组的有效率(80.6%)明显高于阴性组(44.8%),差异有显著意义(χ^(2)=8.277,P<0.01)。化疗有效组性别、年龄、平均病程、体质量指数、肿瘤组织学类型、肿瘤部位和肿瘤长径等指标与无效组比较,差异均无统计学意义(P>0.05);而两组手术切除方式、肿瘤临床分期和MGMT基因启动子甲基化状态等指标相比较,差异均有显著性(χ^(2)=7.542~8.735,P<0.05)。多因素Logistic回归模型分析显示,手术次全切和肿瘤Ⅲ~Ⅳ期为影响脑胶质瘤病人TMZ化疗敏感性的独立危险因素,而MGMT甲基化阳性则为其保护因素(OR=0.651~4.602,95%CI=(0.522~2.456)~(0.723~10.371),P均<0.05)。结论MGMT基因启动子甲基化阳性脑胶质瘤病人的治疗有效率更高,并且甲基化阳性是病人化疗敏感性的保护因素,MGMT甲基化状态可能是评估病人预后的一个重要指标。
Objective To investigate the effect of O6-methylguanine-DNA methyltransferase(MGMT)methylation on the sensitivity to temozolomide(TMZ)chemotherapy in patients with glioma after surgery.Methods A total of 60 patients with glioma who were admitted to Cangzhou Central Hospital from January to December 2022 were enrolled as subjects,and all patients received microsurgery,followed by TMZ chemotherapy after surgery.According to the methylation status of MGMT,the patients were divided into positive methylation group with 31 patients and negative methylation group with 29 patients,and according to the response to chemotherapy,the patients were divided into response group with 38 patients and no-response group with 22 patients.The positive and negative methylation groups were compared in terms of the response to chemotherapy,and univariate and multivariate logistic regression analyses were used to investigate the influencing factors for sensitivity to TMZ chemotherapy.Results The positive methylation group had a significantly higher response rate than the negative methylation group(80.6%vs 44.8%;χ^(2)=8.277,P<0.01).There were no significant differences between the response group and the no-response group in sex,age,average course of disease,body mass index,tumor histological type,tumor location,and tumor diameter(P>0.05),while there were significant differences between these two groups in the pattern of surgical resection,clinical stage of tumor,and the status of MGMT gene promoter methylation(χ^(2)=7.542-8.735,P<0.05).The multivariate logistic regression analysis showed that subtotal resection and tumor stageⅢ-Ⅳwere independent influencing factors for the sensitivity to TMZ chemotherapy in glioma patients,while positive MGMT methylation was a protective factor(OR=0.651-4.602,95%CI=0.522-2.456 to 0.723-10.371,all P<0.05).Conclusion Glioma patients with positive MGMT promoter methylation tend to have a higher response rate,and positive methylation is a protective factor for sensitivity to chemotherapy.The status of MGMT methylation may be an important indicator for assessing the prognosis of glioma patients.
作者
梁盛
朱亮亮
杨峰
董海军
LIANG Sheng;ZHU Liangliang;YANG Feng;DONG Haijun(Department of Pharmacy,Cangzhou Central Hospital,Cangzhou 061000,China)
出处
《青岛大学学报(医学版)》
2025年第4期583-587,共5页
Journal of Qingdao University(Medical Sciences)
基金
河北省医学科学研究课题计划项目(2022-0345)。
作者简介
第一作者:梁盛(1985-),男,硕士,主管药师。E-mail:LIANGslll@163.com。
