摘要
目的:探讨二氢嘧啶脱氢酶(dihydropyrimidine dehydrogenase,DPD)、胸苷酸合成酶(thymidylate synthase,TS)和胸苷磷酸化酶(thymidine phosphorylase,TP)在胃癌中的表达及预后价值。方法:42例胃癌患者于根治术后分别施以5-氟尿嘧啶(5-FU)为主的辅助化疗,并通过免疫组织化学检测DPD、TS和TP的表达,比较上述代谢酶表达与临床病理因素和预后之间的关系。结果:胃癌组织中DPD在肠型中的表达率显著高于弥漫型(65%比25%,P=0.025),TS和TP倾向高表达于分期较晚的胃癌患者中(P<0.05)。DPD阴性者的中位无病生存期显著高于阳性者(25个月比16个月,P=0.012),而中位总生存期阴性组亦显著延长(48个月比26个月,P=0.005),DPD表达是该组胃癌患者无病生存期和总生存期的独立预后因素之一,而TS或TP表达与预后无关(P>0.05)。结论:在接受5-FU为主的辅助化疗胃癌患者中,DPD表达有可能成为重要的预后指标;而TS和TP表达则与肿瘤进展及临床分期密切相关。
Objective To investigate the expressions and prognostic values of dihydropyrimidine dehydrogenase （DPD）, thymidylate synthase（TS） and thymidine phosphorylase（TP） in gastric carcinoma, and to analyze the correlations between the expressions of these enzymes and the clinicopathological features and prognosis. Methods Expressions of DPD, TS and TP were determined by immunohistochemistry in 42 gastric carcinoma patients who had received 5- fluorouracil（5-FU）-based adjuvant chemotherapy after curative resection, and the relationships between the expressions of these metabolic enzyme and the clinicopathological features and prognosis were analyzed. Results In gastric carcinoma, the expression rate of DPD in intestinal type was significantly higher than that in diffused type （65% vs 25%, P=0.025）, TS and TP tended to be higher in patients with gastric carcinoma in advanced stage（P〈0.05）. Patients with DPD negative gastric carcinoma had a significantly better disease free survival compared to those with DPD positive tumor （25 months vs 16 months, P=0.012）, and the median survival of patients with DPD negative carcinoma was significantly longer （48 months vs 26 months, P=0.005）. DPD was an independent prognostic factor of disease free survival and overall survival of gastric carcinoma patients. There was no correlation between expressions of TS or TP and prognosis （P〉0.05）. Conclusions Expression of DPD might be an important prognostic indicator of patients with gastric carcinoma receiving 5-FU- based adjuvant chemotherapy. Expression of TS or TP correlated closely with tumor progression and clinical stage.
出处
《内科理论与实践》
2009年第1期37-40,共4页
Journal of Internal Medicine Concepts & Practice
关键词
胃癌
二氢嘧啶脱氢酶
胸苷酸合成酶
胸苷磷酸化酶
5-氟尿嘧啶
预后
Gastric carcinoma
Dihydropyrimidine dehydrogenase
Thymidylate synthase
Thymidine phosphorylase
5-fluorouracil
Prognosis
