高效液相色谱法检测结直肠癌患者5-FU血药浓度的临床意义  

Clinical significance of 5-FU concentration at steady state in colorectal cancer detected by HPLC method

作　　者：董秋美[1,2] 黄赛花[1,2] 郑伟华[1,2] 何友兼[3] 

机构地区：[1]广东省人民医院肿瘤科 [2]广东省医学科学院,广东广州510080 [3]中山大学肿瘤防治中心内科华南肿瘤学国家重点实验室,广东广州510060

出　　处：《中华肿瘤防治杂志》2010年第18期1476-1478,1481,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省科技计划项目(2007B031515011);广东省科技计划项目(2008B030301181);广东省科技计划项目(2006164)

摘　　要：目的:探讨结直肠癌患者行FOLFOX6方案化疗后5-氟尿嘧啶(5-FU)稳态血药浓度(Css)与疗效及不良反应的相关性和临床意义。方法:收集接受FOLFOX6方案化疗的晚期结直肠癌患者共48例,采用高效液相色谱(HPLC)法检测结直肠癌患者外周血5-FUCss,分析5-FUCss与不良反应、缓解率的关系。结果:5-FUCss在48例结直肠癌患者中不呈正态分布,范围153.7～1094.8μg/L,平均(400.0±190.2)μg/L,个体之间变异较大。随着结直肠癌患者Css的升高,骨髓抑制、口腔黏膜炎及腹泻等不良反应的发生率明显增加,P<0.05。化疗有效患者的平均Css为(469.9±210.8)μg/L,明显高于疾病稳定和进展的患者〔(384.4±127.1)和(257.9±104.2)μg/L〕,P<0.05。结论:结直肠癌患者化疗时Css在300～600μg/L时将获得最佳的疗效和最小的不良反应。OBJECTIVE：To explore the significance of 5-FU Concentration at steady state （Css） in colorectal cancer patients after received FOLFOX6 regimen and its correlation with response rate and toxicities.METHODS：A total of 48 colorectal cancer patients were collected and treated with FOLFOX6 regimen.Peripheral serum concentration of 5-FU at steady state were detected by high performance liquid chromatography methods（HPLC）after the patients received FOLFOX6 regimen.Then relationship of Css of 5-FU with toxicities and response rate were analysed.RESULTS：Css of 5-FU in 48 colorectal cancer patients were abnormal distribution and ranged from 153.7 to 1 094.8 μg/L,with the mean level of （400.0±190.2） μg/L,which showed great variation among the patients.Incidence of myelotoxicity,mucoxitis and diarrhea increased with Css of 5-FU and showed significant difference （P0.05）.The average Css of 5-FU in patients responsed to chemotherapy was （469.9±210.8） μg/L,which was much higher than those patients with stable diseases or progressive diseases：（384.4±127.1） μg/L and （257.9±104.2） μg/L,and with significant difference （P0.05）.CONCLUSION：When Css of 5-FU ranged from 300-600 μg/L,colorectal cancer patients will obtain optimal response rate and less toxicities.

关 键 词：结直肠肿瘤/药物疗法 色谱法 高效液相 氟尿嘧啶 血药浓度 毒性作用 

分 类 号：R735.3[医药卫生—肿瘤]