胸苷酸合成酶与结直肠癌患者FOLFOX方案化疗预后的相关性分析

Association between thymidylate synthase and short and medium term prognosis of FOLFOX chemotherapy in colorectal cancer

目的探讨生物标志物胸苷酸合成酶(TS)基因表达与FOLFOX方案化疗后结直肠癌患者短中期预后的关系。方法纳入本院收治的116例结直肠癌患者,使用改良FOLFOX6(m FOLFOX6)或改良FOLFOX7(m FOLFOX7)方案治疗12疗程后随访1~3年,比较TS的阳性、阴性表达患者的疗效、安全性和3年总生存率。结果 TS+和TS-患者的疗效分布间差异有显著性(χ~2=10.510,P=0.015);TS+和TS-患者的恶心呕吐(χ~2=18.644,P<0.001)、腹泻(χ~2=16.518,P<0.001)和口腔黏膜炎(χ~2=23.344,P<0.001)发生的严重程度分布差异有统计学意义;TS+患者的3年总生存率为38.3%,而TS-为31.4%(Log rankχ2=6.417,P=0.011,HR=1.784,95%CI:1.084~2.936)。结论 TS基因表达情况对结直肠癌患者接受FOLFOX方案化疗的疗效和安全性具有一定预测作用,其中TS还可预测患者中期生存情况。

Objective To investigate the association between the gene expression of thymidylate synthase（ TS） and short mid-term prognosis of FOLFOX chemotherapy in colorectal cancer. Methods 116 patients with colorectal cancer treated during May 2013 to April 2015 in our hospital were included. A modified FOLFOX6（ m FOLFOX6） or FOLFOX7（ m FOLFOX7） program was used for 12 cycles,followed up for 1 ～ 3 years,then curative effect,safety,and 3-year overall survival rate of TS positive,negative expression of patients were compared. Results The distribution of efficacy for patients with TS＋ and TS-had significant difference（ χ2= 10. 510,P = 0. 015）; the severity of nausea and vomiting（ χ2=18. 644,P0.001）,diarrhea（ χ2= 16.518,P0.001） and oral mucositis（ χ2= 23.344,P0.001） in TS ＋ and TS-patients had significant difference; 3-year overall survival rate in patients with TS＋ and TS-were 38.3% and 31.4%,respectively,the difference between the two groups was significant（ Log rank χ2= 6.417,P = 0.011,HR = 1.784,95%CI： 1.084 ～ 2.936）.Conclusion Gene expression of TS had some predictive values in the efficacy and safety in patients with colorectal cancer received FOLFOX chemotherapy,in which TS could predict patient＇s medium term survival.