Expression Genetic Polymorphis Of Thymidylate Synthase And Methylene Tetrahydrofolate Reductase In Clinical Research Of Pemetrexed Therapy In Advanced Lung Adenocarcinoma Patients Of High-altitude Areas

Objective To investigate the polymorphisms expression of TS,MTHFR and the treatment efficacy of pemetrexed and platinum front-line chemotherapy in advanced lung adenocarcinoma patients in high-altitude areas.Methods Seventy-one patients with advanced lung adenocarcinoma were enrolled in this study of from September 2013 to May 2016 in high-altitude areas,and 70 patients were followed up according to the requirements.All patients were EGFR non mutated or unidentified and with pemetrexed and platinum front-line chemotherapy.Among the 30 patients with blood samples of examined and extracted DNA.According to the requirement of follow-up of 29 cases by polymerase chain reaction combined with gel electrophoresis method and the polymorphism of TS and MTHFR gene sequencing.Chi square test was used to the treatment efficacy of pemetrexed-based chemotherapy on the clinical factors and gene polymorphisms.The PFS distributions between the different genotype.Results1.TS ? MTHFR genotype distribution features.13.8% of advanced adenocarcinoma in 29 patients carried 2R/2R genotype,while 34.5% of patients were heterozygotes 2R/3R,and 51.7% of patients were homozygotes 3R/3R.In examined group,there were 34.5% of C/C genotype carriers,48.3% of C/T.genotype and 17.2% of TT genotype of MTHFR gene.2.Between the relationship of TS,MTHFR gene polymorphism and clinical features.TS gene polymorphism gender and age,smoking status,Stage of disease,nation,family history,had no relativity(P>0.05).MTHFR gene polymorphism age and smoking status,Stage of disease,nation,family history,had no relativity(P>0.05).MTHFR gene polymorphism analysis showed that male 34.5%,female,??65.5%,P=0.001,the difference was statistically significant.3.Between relations of chemotherapy curative effect and PFS in TS,MTHFR gene polymorphism.Disease control rate was noted in 65.71% of 70 patients.For whole group of patients,the median time of progression-free survival was 9.59 months.Advanced lung adenocarcinoma in TS gene 3R/3R,2R/2R+2R/3R with DCR is 60.0% and 92.9% respectively,PFS were 11.07 months and 11.29 months respectively 29 patients.MTHFR C/C and C/T + T/T genotype DCR is 70.0% and 78.95%,of PFS were 10.00 months and 11.79 months respectively.Conclusion The TS gene polymorphism and pemetrexed effect treatment of advanced lung adenocarcinoma.MTHFR gene polymorphism and pemetrexed effect treatment of advanced lung adenocarcinoma could not were not significantly correlated in predicting the efficacy in high-altitude Areas.