大肠癌组织TP/DPD比率与卡培他滨化疗毒性的关系

Relationship between TP/DPD ratio in colorectal cancer and toxicity of Capecitabine

目的通过检测大肠癌患者离体肿瘤组织TP和DPD,分析TP/DPD比率与卡培他滨化疗毒性的关系。方法收集了符合入选条件的大肠癌患者33例,取患者肿瘤组织石蜡切片,分别行TP和DPD免疫组化染色,结果判断根据免疫组化1～4评分法进行评分。根据TP/DPD比率的中位数,分为高TP/DPD比值组和低TP/DPD比值组。患者术后2～3周开始卡培他滨化疗,监测卡培他滨化疗毒性,分析患者化疗毒性同其TP/DPD比率的关系。结果高TP/DPD比值组与低TP/DPD比值组比较,两组不良反应差异有统计学意义(P<0.05)。在高TP/DPD比值组内患者之间不良反应的严重程度与TP/DPD比值高度相关。结论 TP/DPD比率与卡培他滨的化疗毒性高度相关,TP/DPD比率高的患者易出现不良反应,且出现严重不良反应的机会大;TP/DPD比率低的患者较少出现不良反应,且出现不良反应的程度轻。

Objective To analysis the correlation between ratio of TP/DPD and toxicity of Capecitabine via evaluation of TP and DPD levels in tumor tissues from patients with colorectal cancer. Methods According to inclusion criteria,33 patients with colorectal cancer were enrolled.TP and DPD of ex vivo tumors were detected by immunohistochemy and rated using a four-stage scoring（1～4） system.The subjects were assigned into high and low TP/DPD groups according to TP/DPD median.Two to three weeks after operation,the patients were given with Capecitabine and the adverse effects were monitored.The correlation between Chemotherapy toxicity and TP/DPD ratio was analyzed. Results Significant correlation was found between adverse effects and TP/DPD ratio（r=-0.878,P=0.021）.Furthermore,significantly higher adverse effects rate was observed in high TP/DPD group than that in low TP/DPD group（P0.05）.Meanwhile,a strong correlation between adverse effects and TP/DPD ratio was proved in high TP/DPD group（r=-1）. Conclusion Patients with high TP/DPD are vulnerable to toxicity of Chemotherapy with Capecitabine.