【摘要】 目的:研究表明大肠癌组织内胸苷酸合成酶(thymidylate systhase,TS)是独立于分期之外影响大肠癌预后的影响因子,TS高水平表达是预后的不良因素,并且与大肠癌患者应用氟脲嘧啶类或其衍生物类药物化疗疗效有关。本研究是探讨对于接受根治术后应用5-氟脲嘧啶或其衍生物化疗的原发性大肠癌患者,TS表达水平高低对患者预后的判断价值。方法:应用免疫组化法检测了89例大肠癌患者的石腊组织标本的TS表达水平。患者为Dukes’A期、B期、C期原发性大肠癌,均接受大肠癌根治术,术后接受5-氟脲嘧啶或其衍生物的4～6周期的化疗。结果:癌组织中TS表达水平比正常组织中TS表达水平高(67.8%vs5.1%,P<0.01)。TS低表达患者与TS高表达患者总生存期、无病生存期无差异(P=0.1785,P=0.0798),多因素分析显示分期是唯一与生存期有关因素。结论:癌组织TS表达水平高低不能预测接受大肠癌根治术且术后接受5-氟脲嘧啶或其衍生物化疗的原发性大肠癌患者的预后,但TS表达水平高的患者可能从辅助化疗中获益。更多还原

【Abstract】 Objectives: Studies showed that thymidylate synthase (TS) was a prognostic factor independent of staging in patients with colorectal cancer (CRC). High TS expression was bad for the prognosis of the patients and it was related with chemotherapy response in patients treated by fluorouracil (5-FU)-based chemotherapy. This study was to analyze the prognostic value of TS expression in primary CRC patients received radical surgery and fluorouracil (5-FU)-based adjuvant chemotherapy. Methods: TS expression was immunohistochemically assessed on formalin-fixed and paraffin-embedded specimens from 89 CRC patients, staged as Dukes’A, B or C. All patients were treated by radical surgery and fluorouracil (5-FU)-based adjuvant chemotherapy. Results: TS expression on tumor sections was higher than that on normal tissues (67.8% vs 5.1%,P<0.01) . There was no significant difference on overall survival and disease-free survival between low or high expression of TS in the tissues (P=0.1785,P=0.0798). Multivariate analyses showed that staging was the single independent prognostic factor. Conclusions: TS expression cannot predict the prognosis in primary CRC patients treated by radical surgery and fluorouracil (5-FU)-based adjuvant chemotherapy. However, it seems that patients with high TS levels may benefit from adjuvant fluorouracil based chemotherapy.更多还原