肿瘤标志物基因表达与FOLFOX方案化疗后结直肠癌短中期预后的关系  

Relationship between the gene expression of cancer biomarkers and short and medium term prognosis of FOLFOX chemotherapy in colorectal cancer

作　　者：周宇 ZHOU Yu(Department of Cancer Chemotherapy,Haikou Hospital Affiliated to Xiangya School of Medicine,Central South University,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院肿瘤化疗科,海口570208

出　　处：《中国临床药学杂志》2020年第5期346-350,共5页Chinese Journal of Clinical Pharmacy

摘　　要：目的探讨肿瘤标志物胸苷酸合成酶(TS)和二氢嘧啶脱氢酶(DPD)基因表达与FOLFOX(草酸铂、四氢叶酸钙和氟尿嘧啶)方案化疗后结直肠癌(CA)3年预后的关系。方法纳入2013年5月1日至2015年5月31日收治的116例结直肠癌患者,采用改良FOLFOX7(mFOLFOX7)或改良FOLFOX6(mFOLFOX6)方案治疗12疗程后随访1~3年,比较TS和DPD基因表达阳性、阴性表达患者的疗效、安全性和3年总生存率。结果 TS表达阳性和TS表达阴性患者的疗效分布不完全相同(χ~2=10.510,P=0.015),DPD基因的表达与疗效之间无明显相关性(P>0.05);TS表达阳性和TS表达阴性患者的恶心呕吐(χ~2=18.644,P<0.05)、腹泻(χ~2=16.518,P<0.05)和口腔黏膜炎(χ~2=23.344,P<0.05)发生的严重程度分布差异有统计学意义;TS表达阳性患者的3年总生存率为38.3%,而TS表达阴性为31.4%,两者比较差异有统计学意义(Log rankχ~2=6.417,P=0.011, HR=1.784, 95%CI:1.084~2.936)。采用COX回归分析显示,临床分期及TS基因表达是影响预后的独立危险因素,差异有统计学意义(P<0.05)。结论 TS基因表达情况对结直肠癌患者接受FOLFOX方式化疗的疗效和安全性具有一定预测作用,其中TS还可预测患者中期生存情况。AIM To investigate the relationship between the gene expression of cancer biomarkers of thymidylate synthase(TS) and dihydropyrimidine dehydrogenase(DPD) and short mid-term prognosis of FOLFOX chemotherapy in colorectal cancer. METHODS From May 1, 2013 to May 31, 2015, 116 patients with colorectal cancer in our department were included in this study. A modified FOLFOX6(mFOLFOX6) or modified FOLFOX7(mFOLFOX7) treatment program were used to treat all of the patients for 12 cycles, and followed up 1-3 years.The and curative effect, safety, and 3-year overall survival rate of TS and DPD positive, negative expression of patients were compared. RESULTS The distribution of difference in efficacy of patients with TS(+) and TS(-)was statistically significant(χ~2=10.510, P=0.015);the distribution of difference in TS(+) and TS(-) patients with nausea and vomiting(χ~2=18.644, P<0.05), diarrhea(χ~2=16.518, P<0.05) and oral mucositis(χ~2=23.344, P<0.05) severity was statistically significant;3-year overall survival rate of patients with TS(+) was 38.3%, while TS(-) was 31.4%, and the difference between 2 groups was statistically significant(Log rank χ~2=6.417, P=0.011, HR=1.784, 95%CI:1.084-2.936). COX regression analysis showed that clinical staging and TS gene expression were independent risk factors affecting prognosis, with statistically significant differences(P<0.05). CONCLUSION The expression of TS gene can predict the efficacy and safety of FOLFOX chemotherapy in patients with colorectal cancer, and the TS can also predict the mid-term survival of patients.

关 键 词：胸苷酸合成酶 二氢嘧啶脱氢酶 结直肠癌 氟尿嘧啶 

分 类 号：R735.34[医药卫生—肿瘤]