非小细胞肺癌组织TS表达与培美曲塞治疗疗效相关性的研究  

Relationship between the expression of thymidylate synthase and pemetrexed for treatment of advanced non-small cell lung cancer

作　　者：邓燕明[1] 梁剑苗[1] 冯卫能[1] 伍婧[2] 张良运[3] 胡维维[3] 

机构地区：[1]佛山市第一人民医院头颈胸肿瘤内科,广东佛山528000 [2]佛山市第一人民医院肿瘤研究所,广东佛山528000 [3]佛山市第一人民医院病理科,广东佛山528000

出　　处：《中华肿瘤防治杂志》2012年第21期1636-1639,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：佛山市科技发展专项资金项目(201008039)

摘　　要：目的:探讨胸苷酸合成酶(TS)表达与培美曲塞治疗晚期非小细胞肺癌(NSCLC)疗效的关系。方法:回顾性分析42例接受培美曲塞联合顺铂或卡铂化疗的晚期NSCLC,免疫组化检测肿瘤组织的TS表达,并对化疗疗效进行分析。结果:42例患者中,TS低表达76.2%(32/42),TS高表达23.8%(10/42)。总客观有效率38.1%(16/42),疾病控制率76.2%(32/42);其中TS低表达患者的客观有效率(43.8%,14/32)与TS高表达患者(20.0%,2/10)差异无统计学意义,χ2=1.822,P=0.177;但TS低表达患者的疾病控制率(84.4%,27/32)明显高于TS高表达患者(50.0%,5/10),χ2=4.063,P=0.026。42例患者的中位无疾病进展时间为5.0个月,中位生存时间为12.5个月;其中TS低表达(6.4个月)患者的中位无疾病进展时间较TS高表达(3.8个月)患者长,P=0.000;但中位生存时间(13.0、8.5个月)差异无统计学意义,P=0.079。结论:TS表达水平可能与培美曲塞的疗效相关,可能是预测培美曲塞治疗晚期NSCLC疗效的生物标志之一。OBJECTIVE： To investigate the relationship between the expression of thymidylate synthase （TS） and pemetrexed treatment for advanced non-small cell lung cancer. METHODS： Fourty-two patients with advanced non-small cell lung cancer who received pemetrexed plus cisplatin or carboplatin treatment were retrospectively studied. The TS expressions in tumor tissues were examined by immunohistochemistry, and the therapeutic effect was analyzed. RESULTS： In 42 cases, TS-negative was 76. 2% （32/42）, and TS-positive was 23. 8% （10/42）. The total response rate was 38. 1% （16/42） and the total disease control rate was 76.2% （32/42）. The response rate in the low TS patient group （43.8%, 14/32） was not statistically significant compared to patients with high TS （20.0%, 2/10）expression （χ^2= 1. 822, P= 0. 177）. Patients with low TS expression （84.4%, 27/32） had significantly higher disease control by pemetrexed treatment than those with TS （ 50.0 %, 5/10） overexpression （ χ^2=4. 063, P = 0.026）. The median progression-free survival （PFS） was 5.0 months and the median overall survival was 12.5 months. Patients with low TS expression （6.4 months） had a longer median progression-free survival （PFS） than those with high TS expression （3.8 months,P= 0. 000）, but the median overall survival was not statistically significant （13.0 and 8.5 months, P= 0. 079）. CONCLUSION： TS expression levels may be related to the efficacy of pemetrexed, and serve as a biomarker to predict the efficacy of pemetrexed for treatment of advanced non-small cell lung cancer.

关 键 词：癌 非小细胞肺 胸苷酸合成酶 药物疗法 

分 类 号：R734.2[医药卫生—肿瘤]