摘要
目的探讨结直肠癌患者肿瘤组织中胸苷酸合成酶(TS)表达情况与氟尿嘧啶(5-Fu)敏感性、临床病理特征及预后的关系。方法选取河北医科大学第四医院2006年10月—2009年4月93例行结直肠癌根治术且病理明确的患者,采用免疫组化方法检测肿瘤组织TS表达情况,同时检测肿瘤组织对5-Fu的敏感性,采用χ2检验分析TS表达与5-Fu敏感性、临床病理特征之间的关系;采用Log-Rank检验、Cox风险回归模型分析不同因素与预后的关系。结果 57例患者(61.3%)TS低表达,36例患者(38.7%)TS高表达。TS表达情况与年龄及hMLH1、hMSH2蛋白表达情况相关(χ2值分别为7.342和4.653,P值分别为0.007和0.031),与性别、肿瘤大体类型、浸润深度、淋巴结转移、远处转移、分期6方面临床病理特征无相关性(P>0.05);TS高表达者较低表达者对5-Fu更敏感(χ2=4.144,P=0.042)。单因素分析显示淋巴结转移、远处转移、TNM分期、hMLH1和hMSH2蛋白表达情况与结直肠癌患者无病生存期有关(P<0.05);多因素分析显示淋巴结转移、远处转移、hMLH1和hMSH2蛋白表达情况与结直肠癌患者无病生存期有回归关系(P<0.05)。结论 TS高表达肿瘤组织对5-Fu更为敏感,TS表达情况与年龄及hMLH1、hMSH2蛋白表达情况密切相关,但与预后无明显相关性。
Objective To investigate the relationship between the thymidylate synthase （TS） expression and sensitivi- ty of fluorouracil, clinical pathologic features and prognosis in patients with colorectal cancer. Methods 93 patients with colorec- tal cancer admitted to the Fourth Hospital of Hebei Medical University were selected form Octomber 2006 to April 2009. TS expres- sion of patients underwent radical surgery and with clear pathology was assessed by standard SP immunohistochemistry （IHC） and sensitivity of fluorouracil was tested by drug sensitivity test in vitro. Chi - square test was used to analyze the relationship between the TS expression sensitivity of fluorouracil and clinicalpathologic features. Log - Rank test, Cox proportional hazard model were used to analyze the relationship between different factors and prognosis. Results 57 patients （61.3%） had low TS expression rate and 36 patients （38.7%） had high TS expression rate. TS expression was related to age and hMLH1, hMSH2 expression sta- tus （ χ2 = 7. 342 and 4. 653, P = 0. 007 and 0. 031 ）, but had no obvious relationship with gender, tumor type, infiltration depth, lymph node metastasis numbers, distant metastasis and stage （ P 〉 0. 05 ） . Patients with high TS expression were more sensitive to fluorouracil compared with patients with low TS expression （χ2=4. 144, P = 0. 042 ） . Univariate analysis showed that lymph node metastasis numbers, distant metastasis, stage and hMLH1 and/or hMSH2 protein expression status were related to the disease free survival of colorectal cancer patients （ P 〈 0.05 ） . Multivariate analysis showed that lymph node metastasis numbers, distant metastasis and hMLH1 and/or hMSH2 protein expression status were dependent factors for the disease free sur- vival of colorectal cancer patients （ P 〈 0. 05 ） . Conclusion Patients with higher TS expression are more sensitive to fluoroura- cil. TS expression status is closely related to age and hMLH1 and/or hMSI-12 protein expression status, but had no obvious rela- tionship with prognosis.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第6期666-670,共5页
Chinese General Practice
基金
河北省医学科学研究重点课题(20110449)
关键词
结直肠肿瘤
胸苷酸合酶
氟尿嘧啶
预后
Colorectal neoplasms
Thymidylate synthase
Fluorouracil
Prognosis
