摘要
目的探讨经颈动脉灌注尼莫司汀对恶性脑胶质瘤患者O^6甲基鸟嘌呤-DNA甲基转移酶(MGMT)基因、突变异柠檬酸脱氢酶-1(IDH1)基因表达及预后的影响。方法回顾性分析2010年1月至2013年1月本院收治的116例恶性脑胶质瘤患者的临床资料。采用随机数表法将入选患者分为观察组与对照组,每组各58例。对照组患者给予放疗,观察组患者在对照组治疗基础上经颈动脉灌注尼莫司汀。比较两组患者治疗前后MGMT基因、突变IDH1基因表达情况及预后。结果两组患者治疗前以MGMT基因高表达为主,组间比较差异无显著性(P>0.05);治疗35天后,观察组患者MGMT基因低表达率与MGMT基因甲基化率均明显高于对照组(P<0.05)。治疗前两组患者突变IDH1基因发现率比较差异无显著性(P>0.05);治疗35天后,观察组患者突变IDH1基因发现率明显高于对照组(P<0.05)。观察组患者治疗有效率明显高于对照组(P<0.05)。两组患者治疗后1年生存率比较差异无显著性(P>0.05),观察组患者治疗后2年与3年生存率均明显高于对照组(P<0.05)。结论在放疗基础上经颈动脉灌注尼莫司汀治疗恶性脑胶质瘤,可以降低MGMT基因表达水平,提高MGMT基因甲基化率和突变IDH1基因发现率,从而提高患者治疗效果和生存率。
Objective To investigate the expression ofO6 methylguanine-DNA methyl transferase （MGMT） gene, mutant isocitrate dehydrogenase-1 （IDH1） gene and the prognosis in patients with malignant glioma treated by transcarotid perfusion of nimustine prognosis. Method The clinical data of 116 malignant glioma patients who admitted in our hospital from January 2010 to January 2013 were retrospectively analyzed. They were divided into observation group and control group by random number table method, 58 cases in each group. Patients in control group were treated with radiotherapy and patients in observation group were infused nimustine via the carotid artery on the basis of control group therapy. The expression level of MGMT, gene IDH1 gene and prognosis were compared between the two groups. Result MGMT expressed high levels in most patients of the two groups and there was no significant difference between the two groups （P 〉 0.05）. After 35-day treatment, the low expression rate of MGMT gene and the methylation rate of MGMT gene in observation group were significantly higher than control group （P ~ 0.05）. Before treatment, there was no significant difference in the rate of mutation of IDH1 gene between the two groups （P 〉 0.05）. After 35-day treatment, the rate of mutation of 1DH1 gene of observation group was significantly higher than control group （P 〈 0.05）. The effective rate of observation group was significantly higher than control group （P 〈 0.05）. There was no significant difference in one-year survival rate between the two groups after treatment （P 〉 0.05）. The two-years survival rate and the three-years survival rate of observation group were significantly higher than control group （P 〈 0.05）. Conelusion Compared with radiotherapy alone in the treatment of malignant glioma, transcarotid perfusion of nimustine may decrease the MGMT gene expression level, increase the MGMT gene methylation rate and mutation 1DH1 gene discovery rate, thus improving the treatment effectiveness and survival rate.
出处
《中国医学前沿杂志（电子版）》
2016年第10期90-94,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
