替吉奥治疗胃癌的临床疗效与外周血内DPD mRNA和TS mRNA表达水平的相关性

The correlation of clinical efficacy of S-1 in treating gastric cancer with the expressions of DPD mRNA and TS mRNA in peripheral blood

目的分析替吉奥(S-1)治疗胃癌的临床疗效与外周血内二氢嘧啶脱氢酶(Dihydropyrimidine dehydrogenase,DPD)mRNA和胸苷酸合成酶(Thymidine synthetase,TS)mRNA表达水平的相关性。方法选取唐山市人民医院2013年3月-2014年3月接受含S-1方案治疗的75例胃癌患者为研究对象,并进行前瞻性分析。患者化疗前抽取空腹静脉血7 ml,并检测其DPD mRNA、TS mRNA表达水平。结果 Lauren分型为肠型患者的DPD mRNA高表达率高于弥漫型患者;有远处转移患者的TS mRNA高表达率高于无远处转移者(P<0.05)。疗效判定为进展(PD)的患者,DPD、TS mRNA表达水平高于部分缓解(PR)、稳定(SD)患者;PR患者外周血DPD、TS mRNA表达水平低于SD患者(P<0.05)。DPD mRNA、TS mRNA表达与临床疗效均呈负相关(r=-0.713,r=-0.735,P<0.05)。不同毒副作用分级患者外周血DPD mRNA与TS mRNA表达比较,差异无统计学意义(P>0.05)。外周血DPD mRNA及TS mRNA高表达患者OS低于低表达患者(P<0.05)。结论根据患者外周血DPD mRNA和TS mRNA表达水平可早期评估患者预后及治疗效果,为胃癌患者生存质量的改善奠定基础。

Objective To analyze the correlation of clinical efficacy S-1 in treating gastric cancer with the expressions of Dihydrogen Dihydropyrimidine dehydrogenase （PD） mRNA and Thymidine synthase （TS） mRNA in peripheral blood. Methods Seventy-five patients with gastric cancer who were treated with S-1 in People＇ s Hospital of Tangshan City from Mar. 2013 to Mar. 2014 were selected and analyzed prospectively. 7 ml of fasting venous blood before chemo-therapy was collected and the DPD mRNA and TS mRNA expression levels were detected. Results The high expression rate of DPD mRNA was higher than that of diffuse type, there was a higher expression rate of mRNA TS in the patients with distant metastasis than those without distant metastasis, and the difference was statistically significant （P 〈 0.05）. The DPD mRNA and TS mRNA expression levels of patients with progressive disease （PD） were significantly higher than those in partial remission （PR） , stable （SD） patients. The serum DPD mRNA and TS mRNA expression levels in PR patients were significantly lower than those in SD patients, the difference was statistically significant （P 〈 0.05）. The DPD mRNA and TS mRNA expressions were negatively correlated with clinical efficacy （r =- 0. 713, r =- 0. 735, P 〈 0.05）. There was no significant difference in the expressions of DPD mRNA and TS mRNA in peripheral blood of patients with different toxic and side effects （P 〉 0.05）. The DPD mRNA and TS mRNA patients with high expression of peripheral blood OS were significantly lower than those with low expression, and the difference was statistically significant （P 〈 0.05）. Conclusion According to the peripheral blood DPD mRNA and TS mRNA expression levels of early assessment of prognosis and therapeutic effect, for the improvement of quality of life in patients with gastric cancer lay the foundation.