TS mRNA水平对食管癌化疗的预测价值

Thymidylate Synthase mRNA Level in Untreated Esophageal Cancer Tissue and Its Prediction to Efficacy of Chemotherapy with Cisplatin and 5-fluorouracil

目的探讨化疗前食管癌组织中胸苷酸合成酶(thymidylate synthase,TS)转录水平及其对顺铂/5-氟脲嘧啶(DDP/5-Fu)疗效的预测价值.方法 20例食管癌患者均接受2个周期DDP/5-Fu化疗.DDP 15～20 mg/m2/d,iv d1-5;5-Fu 375～500 mg/m2/d,ivgtt 8 h,d1-5,休息4周后,进行第二个周期化疗.以β-肌动蛋白(β-actin)作内参照,应用半定量RT-PCR技术检测化疗前食管癌癌组织中TS mRNA水平,以TS/Β-actin比值表示.实验数据经SPSS 10.0统计软件处理,化疗有效和无效组间TS mRNA水平间差异分析采用Wilcoxon秩和检验;双侧检验,α取0.05作为显著性检验的标准.结果 20例食管癌患者中,11例化疗有效者的TS/β-actin mRNA水平中位值为3.90×10-1,而9例化疗无效者的TS/β-actin mRNA水平中位值为9.10×10-1,两组差异具有统计学意义(P<0.05).结论化疗前食管癌组织中TS mRNA水平对应用DDP/5-Fu治疗食管癌的疗效具有一定预测价值.

Objective To evaluate the predictive effect of the thymidylate synthase mRNA level to the response of the chemotherapy with cisplatin and fluorouracil in untreated esophageal cancer by detecting the thymidylate synthase. Methods 20 patients with untreated esophageal cancer accepted two cycles combined chemotherapy with cisplatin and 5-fluorouracil.cisplatin 15~20mg/m 2/d was intravenously infused in consecutive five days and 5-fluorouracil 375～500 mg/m 2/d was intravenously infused for eight hours per day in consecutive five days per cycle, there were four weeks gap between two cycles. β-actin was used as a internal reference gene and the mRNA level of TS/β-actin in esophageal cancer tissue was determined by semi-quantitative reverse-transcription polymerase chain reaction(RT-PCR). Data was analysed by Wilcoxon rank sum test in SPSS 10.0 statistical program.There was a statistical significance, when P< 0.05 occurred with two-sided test. Results For 20 untreated esophageal cancer patients,the median of TS mRNA level from 11 responding patients was higher than that of 9 nonresponding patients. There was a significant difference between the two groups(Wilcoxon rank sum test,P< 0.05). Conclusion The TS mRNA level has a certain predictive value to the efficacy of chemotherapy with cisplatin and fluorouracil in esophageal cancer.