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目的:探讨多药耐药基因1(MDR1)多态性与肝细胞癌(HCC)肝移植预后的关系。方法:采用PCR-限制性片段长度多态性(PCR-RFLP)法检测50例HCC肝移植患者MDR1基因第1236位C→T(C1236T)、第2677位G→A/T(G2677A/T)和第3435位C→T(C3435T)的基因型,进而分析其与预后的关系。结果:MDR1C1236T、G2677T、C3435T基因型对患者预后无明显影响,而2677A基因型与预后相关。Log-rank检验结果显示:MDR1 2677A携带型的无瘤生存率显著高于非携带型,是影响HCC肝移植术后无瘤生存率的因素之一(P<0.05);多因素分析结果显示:MDR1 2677A携带情况是影响无瘤生存率的独立因素(RR=0.143,P<0.01)。结论:在MDR1 2677位点上A的携带情况是影响肝癌肝移植无瘤生存的独立因素。
Objective: To investigate the relationship between the multidrug resistance gene 1 (MDR1) polymorphism and the prognosis of hepatocellular carcinoma (HCC) liver transplantation. Methods: PCR-RFLP was used to detect the frequencies of C → T (C1236T) and G → A / T (G2677A / T) at the 1277th position of MDR1 gene in 50 HCC patients. And 3435 C → T (C3435T) genotype, and then analyze its relationship with the prognosis. Results: The genotypes of MDR1C1236T, G2677T and C3435T had no significant effect on the prognosis of patients, while the genotype of 2677A correlated with the prognosis. Log-rank test showed that MDR1 2677A carrier-based tumor-free survival rate was significantly higher than non-carrier-based, is one of the factors that affect the tumor-free survival rate after liver transplantation (P <0.05); Multivariate analysis showed that: The carriage of MDR1 2677A was an independent factor affecting the disease-free survival (RR = 0.143, P <0.01). Conclusion: The carrying status of A at site 2677 of MDR1 is an independent factor affecting the survival of hepatocellular carcinoma without liver transplantation.