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目的:探讨胸苷酸合成酶(TS)表达水平在培美曲塞治疗晚期肺腺癌患者疗效的意义。方法:回顾性分析30例接受培美曲塞联合顺铂化疗的ⅢB/Ⅳ期肺腺癌患者,运用免疫组织化学方法检测患者癌组织中TS蛋白表达,并随访1年,对化疗疗效进行分析。结果:30例患者中,TS阳性表达率为23.33%,TS表达与患者的性别、年龄及临床分期无关(P>0.05)。TS表达阴性患者客观缓解率(RR)为43.48%,而TS表达阳性患者RR为14.29%,差异无统计学意义(P=0.215>0.05);TS蛋白表达阴性患者疾病控制率(DCR)为91.30%,TS蛋白表达阳性患者DCR为42.86%,差异有统计学意义(P=0.016<0.05)。Kaplan-Meier生存曲线显示:TS蛋白阴性表达者1年DFS高于阳性表达者,差异有统计学意义(P=0.047<0.05)。结论:TS可作为预测肺腺癌患者对培美曲塞的敏感性的指标,TS表达阴性肺腺癌患者可以从含培美曲塞的化疗方案中获益。
Objective: To investigate the significance of the expression of thymidylate synthase (TS) in patients with advanced lung adenocarcinoma treated with pemetrexed. Methods: Thirty patients with stage ⅢB / Ⅳ lung adenocarcinoma who received pemetrexed combined with cisplatin chemotherapy were retrospectively analyzed. The expression of TS protein in the cancer tissue was detected by immunohistochemistry and followed up for 1 year, and the effect of chemotherapy was analyzed . Results: The TS positive expression rate was 23.33% in 30 patients. The TS expression was not related to the sex, age and clinical stage (P> 0.05). The objective response rate (RR) was 43.48% in patients with TS negative expression and 14.29% in TS positive patients (P = 0.215> 0.05). The disease control rate (DCR) in patients with TS negative expression was 91.30 %, TSR positive patients DCR was 42.86%, the difference was statistically significant (P = 0.016 <0.05). The Kaplan-Meier survival curves showed that the 1-year DFS of TS protein was higher than that of the positive expression in TS protein, the difference was statistically significant (P = 0.047 <0.05). CONCLUSIONS: TS can be used as a predictor of sensitivity to pemetrexed in patients with lung adenocarcinoma. Patients with TS-negative lung adenocarcinoma may benefit from pemetrexed-containing chemotherapy.