海南黎族肺腺癌患者胸苷酸合酶mRNA表达水平对培美曲塞化疗预后的影响

Prognostic Impact of Thymidylate Synthase mRNA Expression Level in Hainan Li Nationality Lung Adenocarcinoma Patients Treated with Pemetrexed

目的探讨海南黎族肺腺癌患者癌组织中胸苷酸合酶(TS)mRNA表达水平对培美曲塞辅助化疗预后的影响。方法选取2008年6月—2009年4月在我院手术治疗的晚期肺腺癌患者52例,采用培美曲塞为主的方案进行辅助化疗。采用反转录聚合酶链反应(RT-PCR)和相对定量的方法分别检测患者癌组织及癌旁组织中TS mRNA的表达水平,分析TS mRNA表达水平对患者化疗预后的影响。结果 52例肺腺癌患者中,35例(67.3%)癌组织TS mRNA表达水平低于其癌旁组织。52例肺腺癌患者癌组织中TS基因mRNA表达水平相差67倍,以临界值(cut-off均值)为界,TS mRNA高表达患者29例(55.8%),低表达患者23例(44.2%)。癌组织中TS mRNA低表达组患者的无复发生存率(61.0%)和总生存率(56.5%)均高于高表达组(39.0%和43.5%)(P<0.05)。结果癌组织中TS mRNA低表达的患者更能从培美曲塞为主的辅助化疗方案中受益;检测癌组织中TS mRNA表达水平有助于预测患者对化疗药物的敏感性。

Objective To investigate the prognostic impact of thymidylate synthase（ TS） mRNA expression level in Hainan Li nationality lung adenocarcinoma patients treated with pemetrexed.Methods A total of 52 patients with advanced lung adenocarcinoma who had surgery in our hospital from June 2008 to April 2009,were selected as study subjects.All patients received adjuvant chemotherapy,pemetrexed was the main chemotherapeutic drug.RT- PCR and relative quantification method were used to detect the expression levels of cancer tissues and paracancerous tissues.The prognostic impact of TS mRNA expression level in patients who received chemotherapy was analyzed.Results Of 52 patients,TS mRNA expression levels of cancer tissues were significantly lower than those of paracancerous tissues in 35 cases（ 67.3%）.Of 52 patients,the highest TS mRNA expression level was 67 times as much as the lowest TS mRNA expression level of cancer tissues.According to median value of cut- off value,there were 29 patients（ 55.8%） with high expression of TS gene mRNA in carcinoma tissue,and there were 23 patients（ 44.2%） with low expression.The recurrent- free survival rate（ 61.0%） and overall survival rate（ 56.5%） of patients in low TS mRNA expression level group were significantly higher than those（ 39.0% and 43.5%） of patients in high TS mRNA expression level group,respectively（ P 〈0.05）.Conclusion The patients with low expression level of TS mRNA in carcinoma tissue can benefit from adjuvant chemotherapy with pemetrexed.Detection of TS mRNA expression levels in cancer tissues can predict the sensitivity to chemotherapeutic drugs.