关键词: 局部晚期食管癌, 顺铂, 同步放化疗, 表皮生长因子, 基因多态性

Abstract: Objective The aim of this study was to analyze the relationship between polymorphism of epidermal growth factor(EGF)gene and sensitivity of concurrent chemoradiotherapy(CCRT)regimen containing cisplatin in esophageal cancer patients. Methods A prospective cohort study was conducted in 112 esophageal cancer patients who underwent CCRT treatment in Tianchang City People′s Hospital and Haimen People′s Hospital from March 2020 to February 2024 as the research subjects.All patients underwent EGF gene polymorphism detection and pathological features were analyzed at admission.The genotypes and alleles of EGF G-61A locus were counted.All patients were evaluated for the effect at 4 cycles of CCRT treatment.According to the pathological evaluation criteria established by Becker et al.the patients were divided into the CCRT-tolerant group and CCRT-sensitive group.The EGF G-61A locus gene polymorphism and clinicopathological features were compared between the two groups,and the relationship between EGF G-61A locus polymorphism and CCRT sensitivity of esophageal cancer was analyzed. Results A total of 112 patients with esophageal cancer were enrolled in this study,of which 106 patients were followed up.The results of EGF G-61A locus genotype detection showed that among the 106 patients,33 cases had GG genotype,45 cases had GA genotype,and 28 cases had AA genotype.The results of allele detection showed that 73 cases had G allele and 33 cases had A allele.The results of CCRT treatment showed that 28 patients were tolerant to CCRT treatment and 78 patients were sensitive to CCRT treatment.The proportion of TNM stage IVa,poor differentiation and CCRT tolerance in patients with EGF G-61A GG genotype was higher than that in patients with GA and AA genotypes.The proportion of TNM stage Ⅳa,low differentiation and CCRT tolerance in patients with EGF G-61A G allele was higher than that in patients with A allele.The difference was statistically significant(P＜0.05).The proportion of TNM stage IVa and low differentiation in the CCRT tolerance group was higher than that in the CCRT sensitive group,and the proportion of EGF G-61A GG genotype and G allele was higher than that in the CCRT treatment sensitive group,with significant differences(P＜0.05).Logistic regression analysis showed that TNM stage IVa,poor differentiation,EGF G-61A GG genotype,and G allele were risk factors for CCRT tolerance in esophageal cancer(P＜0.05). Conclusion The sensitivity of patients with esophageal cancer to CCRT regimen containing cisplatin is related to EGF G-61A gene polymorphism,and the EGF G-61A GG genotype and G allele may increase the risk of CCRT tolerance.

Key words: Locally advanced esophageal cancer, Cisplatin, Concurrent chemoradiotherapy, Epidermal growth factor, Gene polymorphism