胸苷酸合成酶在非小细胞肺癌中的表达与培美曲塞疗效相关性研究

Correlative study of thymidylate synthase expression in non-small cell lung cancer and treatment efficacy of pemetrexed

目的评价胸苷酸合成酶(TS)在非小细胞肺癌(NSCLC)中的表达与培美曲塞疗效的相关性。方法选择经病理检查确诊的106例复治晚期NSCLC患者,予培美曲塞500 mg/m2,静脉滴注,第1天,每3周1次,采用免疫组化方法分析TS蛋白表达,并采用半定量组织评分方法进行评价。结果 TS表达与培美曲塞疗效呈正相关(P=0.02)。TS低表达患者较TS高表达者有较长的中位无进展生存期(PFS),分别为4.8、3.4个月,差异有统计学意义(P=0.01)。在腺癌患者中TS低表达患者较TS高表达者有较长的中位PFS,分别为4.8、3.8个月,以及中位总生存期(OS),分别为21.4、10.0个月,差异有统计学意义(P=0.03)。结论 TS在NSCLC中的表达与培美曲塞疗效显著相关。TS表达的预测作用在未来的随机研究中值得进一步探讨。

Objective To evaluate the correlation between thymidylate synthase（TS） expression in non-small cell lung cancer（NSCLC） and the treatment efficacy of pemetrexed.Methods 106 retreatment patients with advanced NSCLC diagnosed by pathology were intravenously given pemetrexed 500 mg/m2on 1st d,once every 3 weeks.The TS expression was immunohistochemically analyzed and evaluated by the semiquantitative histological scoring method（H-score）.Results The TS expression was positively correlated with the treatment efficacy of pemetexed-based chemotherapy（P=0.02）.The patients with low TS expression had a longer median progression-free survival（PFS） than those with high TS expression（4.8 months vs.3.4 months） with statistically significant difference（P=0.01）.In the patients with adenocarcinoma,the low TS expression group also had a longer median PFS（4.8 months vs.3.8 months） and a longer median overall survival（OS,21.4 months vs.10.0 months）as compared with the high TS expression group with statistically significant difference（P=0.03）.Conclusion The TS expression in NSCLC patients is significantly correlated with the clinical efficacy of pemetrexed,and its predictive role deserves to be further researched in the prospective randomized study.