【作者】 董秋美； 郑伟华； 张鹏； 何友兼；

【Author】 Dong Qiu-Mei Zheng Wei-Hua Zhang Peng He You-Jian

【机构】 广东省人民医院肿瘤内科； 广州市儿童医院外科； 中山大学肿瘤防治中心内科；

【摘要】 目的:5-FU是结直肠癌患者化疗的主要用药。5- FU在体内的代谢过程具有明显的个体差异性。临床工作中发现结直肠癌患者按照体表面积给药,化疗疗效和不良反应却明显不同,有些患者甚至出现严重的不良反应。本研究通过检测结直肠癌组织及其周围正常肠粘膜组织DPD的表达, 同时观察患者因化疗引起的不良反应,探讨预测化疗不良反应的方法,为临床进行个体化治疗提供依据。方法:收集 2004年6月至2004年12月期间在中山大学肿瘤医院腹部外科就诊的结直肠癌患者的结直肠癌组织及其周围正常肠粘膜组织标本各36份,所有患者均在我院接受手术及FOLFOX6 方案化疗,同时观察患者的不良反应。用RT—PCR法检测36 例结直肠癌患者肠癌组织及其正常肠粘膜组织DPD的表达, 并分析DPD的表达和接受FOLFOX6方案化疗后毒性的相关性。结果:36例患者出现的不良反应主要包括胃肠道反应 (恶心、呕吐)、骨髓抑制、口腔粘膜炎、腹泻、脱发等。DPD 在肠癌组织的表达和各种不良反应无相关性,DPD在正常肠粘膜的表达状况和口炎、腹泻的发生率成负相关(P≤0．05), 和胃肠道反应、骨髓抑制、脱发等无相关性。结论:通过检测正常肠粘膜DPD的表达可以预测患者化疗后口炎、腹泻的发生情况。更多还原

【Abstract】 Objective: 5-fluorouracil(5-FU) is the main drug used in chemotherapy for colorectal cancer (CRC) patients.However metabolism of 5-FU showed high-variation among patients. The toxicities and response were different when the patients of colorectal cancer were treated with the same regimen containing 5-FU,some patients even suffered from severe toxicities. The study was to detect expression of Dinydropyrimidine dehydrogenase(DPD) in colorectal cancer tissues and adjacent normal mucosa, and observe toxicities due to chemotherapy of 5-FU, to explore the method of predicting toxicities and provide evidence for individualized chemotherapy. Methods: To collect 36 patients with colorectal cancer admitted to Sun Yat-Sen university cancer center.All patiernts received operation and chemotherapy with FOLFOX6. The expression of DPD were detected by reverse transcription polymerase chain reaction (RT-PCR) method in 36 colorectal cancer tissues and adjacent normal mucosa, correlation between DPD and toxicities were analyszed. Results: The toxicities of 36 patients were mainly nausea and vomiting, myelotoxicities, mucositis, diarrhea, neurological toxicities,alopecia,etc.The expression of DPD in colorectal cancer tissues has no correlation with toxicities, the expression of DPD in normal colorectal mucosa was reversed related to mucositis and diarrhea (P ≤ 0.05). Conclusion: The mucositis and diarrhea can be predicted by the detection of DPD in normal colorectal tissues.更多还原