Prediction Of The Recentefficacy Of CTLA-4 Gene Promoter SNP In The Treatment Of Non-small Cell Lung Cancer

Objective: To investigate the distribution of CTLA-4 gene 7 SNPs(rs11571315,rs11571316,rs16840252,rs231775,rs231779,rs35219727,and rs5742909)in NSCLC patients and their correlation with the short-term efficacy after radiotherapy in order to find out the functional SNPs that could predict the efficacy of NSCLC radiotherapy.In order to improve the efficacy of radiotherapy in NSCLC patients,to provide guidance for individualized treatment.Methods: 159 NSCLC patients undergoing radical intensity-modulated radiotherapy were selected.Before the start of radiotherapy,peripheral blood samples were collected from the patients and DNA was extracted.The 7 SNP of CTLA-4 gene were detected by mass spectrometry.The computed tomography of lung was reviewed 4 weeks and 12 weeks after the end of radiotherapy.The evaluation of the efficacy of the review patients was performed using the Response Evaluation Criteria in Solid Tumors RECIST Version1.1.The spss22.0 version was used for statistical analysis of the experimental results.The?2 test was used to statistically analyze the distribution of different alleles and different genotypes of SNPs in the effective group(CR+PR)and the ineffective group(SD+PD).The odds ratio(OR)and its 95% confidence interval(CI)were calculated using an unconditional logistic regression model.All OR values were corrected by confounding factors such as age and sex.The Pearson correlation analysis was used to calculate the rs5742909 and rs16840252 two-gene correlations.All tests were bilateral,and P < 0.05 was considered statistically significant.Results: 1.The distribution of alleles and genotypes of six SNPs(rs11571315,rs11571316,rs16840252,rs231775,rs231779 and rs5742909)in CTLA-4 gene was not statistically different in the pathological subtypes of NSCLC(P>0.05).2.The allelic distribution of rs16840252 and rs5742909 was associated with radiotherapy efficacy at 4weeks and 12 weeks after NSCLC radiotherapy(P<0.05),and CT+TT genotype carriers were compared with CC genotype carriers have a poor efficacy at 4 weeks(OR=2.441,95%CI:1.128–5.152,P=0.023 & OR=2.680,95%CI:1.227–5.856,P=0.013)and 12weeks(OR=2.607,95%CI:1.235–5.501,P=0.012 & OR=2.881,95%CI:1.338–6.205,P=0.007)after radiotherapy.3.The genotypic distribution of rs5742909 was associated with radiotherapy efficacy at 4 weeks and 12 weeks after NSCLC radiotherapy(P<0.05),and rs16840252 was only associated with radiotherapy efficacy at 12 weeks after NSCLC radiotherapy(P<0.05).CT genotype carriers are less effective than CC genotype carriers at 4 weeks(OR=2.653,95%CI:1.178–5.979,P=0.019 & OR=2.376,95%CI:1.082–5.218,P=0.031)and 12 weeks(OR= 3.219,95% CI: 1.427–7.264,P=0.005,in rs5742909)after radiotherapy.4.Both rs5742909 and rs16840252 were significantly associated with two tails on the 0.01 th layer(P<0.05,R=0.938).Conclusion: In patients with NSCLC,the two rs5742909 or rs16840252 mutations in CTLA-4 gene promoter region resulted in poorer efficacy after radiotherapy.