DPDmRNA及TSmRNA表达与进展期胃癌患者含替吉奥方案的化疗临床预后的关系

Relationship between the DPD and TSmRNA expressions and the prognosis to S-1-based chemotherapy in patients with advanced gastric cancer

目的探讨二氢嘧啶脱氢酶(Thymidine phosphorylase,DPD)m RNA及胸苷酸合成酶(Thymidylate synthase,TS)m RNA表达与进展期胃癌患者含替吉奥方案的化疗临床预后的关系。方法经病理学确诊的进展期胃癌患者40例,化疗前抽取外周血采用RT-PCR法检测DPDm RNA及TSm RNA表达水平,给予含替吉奥的方案:替吉奥+顺铂化疗。分析DPDm RNA及TSm RNA表达与进展期胃癌患者含替吉奥方案的化疗临床预后的关系。结果 40例进展期胃癌患者中,至随访结束,40例患者中位OS为13.5个月,其中DPD低表达者为17个月,DPD高表达者为10个月,差异有显著统计学意义(χ2=4.059,P=0.044)。TS低表达者为17个月,TS高表达者为10个月,差异有显著统计学意义(χ2=3.936,P=0.047)。联合分析显示,DPD低表达且TS低表达的患者表现出更长的OS(χ2=17.486,P=0.001)。结论 DPDm RNA及TSm RNA表达可单独或联合用于预测进展期胃癌患者对含替吉奥方案的预后。

Objective To explore the relationship between the thymidine phosphorylase（DPD） and thymidylate synthase（TS） m RNA expressions and S-1-based chemotherapy prognosis in patients with advanced gastric cancer（AGC）. Methods A total of 40 patients with pathologically confirmed AGC were enrolled in this study. Before the treatment, the expressions of DPD and TS m RNA in peripheral blood were determined using reverse transcription polymerase chain reaction（RT-PCR）. Then the patients were administered with S-1-based regimen（S-1＋cisplatin）. The relationship between the DPD and TS m RNA expressions and prognosis in AGC patients were analyzed. Results The median OS was 13.5 months in these 40 patients. It was 17 months in patients with low DPD m RNA expression and10 months in those with high DPD m RNA expression（ χ^2=4.059, P=0.044）. Also, it was 17 months in patients with low TS m RNA expression and 10 months in those with high TS m RNA expression（χ^2=3.936, P=0.047）. Pooled analysis showed that patients with both low DPD m RNA expression and low TS m RNA expression had even longer OS（χ^2=17.486, P=0.001）. Conclusion The detection of DPD and TS m RNA expression alone or in combination can be used to predict the prognosis in AGC patients.