Study On The Value Of Gene Detection In Individualized Chemotherapy Of Advanced Gastric Cancer After Surgery

Objective:To explore the significance of ERCC1,RRM1,TYMS and TOP2A gene mRNA detection in individualized chemotherapy after o surgery of advanced gastric cancer.Methods:80 patients with advanced gastric cancer who met the inclusion criteria receivedchemotherapy after D2 radical operation.These patients were divided into two groups:40 patients’chemotherapy is the choice of chemotherapy based on genetic testing,40 patients’chemotherapy is traditional first-line chemotherapy.40 of them did not carry out gene detection and used the standard two drug XELOX program.In addition,genetic testing group were detected by DNA liquid phase method for ERCC1,RRM1,TYMS and TOP2A gene mRNA expression level.The low expression level of ERCC1 was sensitive to platinum,the low expression level of RRM1 was sensitive to gemcitabine,the low expression level of TYMS was sensitive to fluorine,and the high expression level of TOP2A was sensitive to anthracycline.According to the detection results,the above drugs were selected as chemotherapy plan.The efficiency of chemotherapy,tumor associated antigen,one-year and two-year survival rate,adverse reactions and median survival time were observed and compared between the two groups.Results:In the genetic testing group,the expression rate of ERCC1 gene was 20%,RRM1 gene was 10%,TYMS gene was 12.5%,and TOP2A gene was 27.5%.The effective rate of chemotherapy was 65%in genetic testing group and 52.5%in non-genetic testing group.There was no significant difference between genetic testing group and non-genetic testing group(P>0.05).The incidence of blood system toxicity,nervous system toxicity(hand foot syndrome)and oral mucositis in genetic testing group was significantly lower than that in non-genetic testing group.CEA and CA199 in the genetic testing group and the non-genetic testing group were significantly lower than those before chemotherapy(P<0.05),and the decrease in CEA and CA199 in the genetic testing group was lower than that in the non-genetic testing group(P<0.05)The two-year survival rate of genetic testing group was 53.8%,and that of non-genetic testing group was 39.5%,there was no significant difference(P>0.05);the median survival time of genetic testing group was 14.8 months,and that of non-genetic testing group was 12.2 months,there was significant difference between genetic testing group and non-genetic testing group(P<0.05).Conclusion:1.By detecting the mRNA expression levels of ERCC1,RRM1,TYMS and TOP2A,the side effects of chemotherapy in patients with advanced gastric cancer were significantly reduced.CEA and CA199 were significantly decreased and the median survival time was prolonged in patients with advanced gastric cancer.2.There was no significant difference in 1-year and 2-year follow-up survival rates,which may be related to the short follow-up time and small sample size.3.The detection of ERCC1,RRM1,TYMS and TOP2A genes has a certain guiding significance for the individualized chemotherapy after the operation of advanced gastric cancer,which may be the basis for the selection of individualized chemotherapy after the operation of advanced gastric cancer with more clinical application value.