[1]胡德升,高 磊,王 江,等.外周血胸苷酸合成酶基因表达与中晚期结直肠癌患者FOLFOX4化学治疗敏感性和预后的相关性[J].新乡医学院学报,2020,37(10):930-934.[doi:10.7683/xxyxyxb.2020.10.007]
 HU Desheng,GAO Lei,WANG Jiang,et al.Correlation between thymidylate synthase gene expression in peripheral blood and FOLFOX4 chemotherapy sensitivity and prognosis of patients with advanced colorectal cancer[J].Journal of Xinxiang Medical University,2020,37(10):930-934.[doi:10.7683/xxyxyxb.2020.10.007]
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外周血胸苷酸合成酶基因表达与中晚期结直肠癌患者FOLFOX4化学治疗敏感性和预后的相关性
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年10
页码:
930-934
栏目:
临床研究
出版日期:
2020-10-05

文章信息/Info

Title:
Correlation between thymidylate synthase gene expression in peripheral blood and FOLFOX4 chemotherapy sensitivity and prognosis of patients with advanced colorectal cancer
作者:
胡德升1高 磊1王 江1刘寒松1吴慧丽2
(1.郑州大学附属郑州中心医院胃肠疝外科,河南 郑州 450000;2.郑州大学附属郑州中心医院消化内科,河南 郑州 450000)
Author(s):
HU Desheng1GAO Lei1WANG Jiang1LIU Hansong1WU Huili2
(1.Department of Gastrointestinal Hernia Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan Province,China;2.Department of Gastroenterology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan Province,China)
关键词:
结直肠癌中晚期胸苷酸合成酶基因化学治疗敏感性
Keywords:
colorectal cancermiddle and late stagethymidylate synthase genechemotherapy sensitivity
分类号:
R735.3
DOI:
10.7683/xxyxyxb.2020.10.007
文献标志码:
A
摘要:
目的 探讨外周血胸苷酸合成酶(TYMS)基因表达与中晚期结直肠癌(CRC)患者FOLFOX4化学治疗敏感性和患者预后的相关性。方法 回顾性分析2014年6月至2016年5月郑州大学附属郑州中心医院收治的120例接受FOLFOX4化学治疗的中晚期CRC患者的临床资料。采用聚合酶链反应及实时荧光定量聚合酶链反应法检测患者外周血中TYMS的基因型及其相对表达量,根据不同基因型患者TYMS mRNA表达情况分为低表达组(n=35)和高表达组(n=85)。分析TYMS mRNA表达与患者临床病理学参数、治疗效果及预后的关系;采用Kaplan-Meier法绘制生存曲线,比较2组患者3 a生存率。结果 120例中晚期CRC患者中3R/3R、2R/2R、2R/3R基因型占比分别为70.83%(85/120)、12.5%(15/120)、16.67%(20/120)。TYMS 2R/2R与2R/3R基因型mRNA相对表达量比较差异无统计学意义(P>0.05),TYMS 3R/3R基因型mRNA相对表达量显著高于2R/2R、2R/3R基因型(P<0.05)。TYMS表达与患者的性别、年龄、组织学分型、肿瘤部位、分化程度、浸润深度无关(P>0.05),与患者TNM分期、淋巴结转移有关(P<0.05)。TYMS高表达组和低表达组患者治疗有效率分别为62.35%(53/85)、91.43%(32/35),TYMS低表达组患者治疗有效率显著高于高表达组(χ2=10.732,P<0.05)。 TYMS高表达、TNM分期Ⅳ期、有淋巴结转移是影响中晚期CRC患者临床疗效的独立危险因素(OR=2.259、2.484、2.540,P<0.05),TYMS高表达、有淋巴结转移是影响中晚期CRC患者预后的独立危险因素(OR=1.371、2.640,P<0.05)。 TYMS高表达组和低表达组患者 3 a生存率分别为63.53%(54/85)、88.57%(31/35),TYMS低表达组患者3 a生存率显著高于高表达组(χ2=7.401,P<0.05)。结论 TYMS mRNA表达与中晚期CRC患者FOLFOX4化学治疗敏感性密切相关,TYMS低表达可增强患者对FOLFOX4化学治疗方案的敏感性,提高治疗效果。
Abstract:
Objective To investigate the expression of thymidylate synthase (TYMS) gene in peripheral blood and its correlation with the chemosensitivity of FOLFOX4 and prognosis of patients with advanced colorectal cancer (CRC).Methods The clinical data of 120 patients with advanced CRC underwent FOLFOX4 chemotherapy in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2014 to May 2016 were analyzed,retrospectively.The TYMS genotype and its relative expression in peripheral blood were detected by polymerase chain reaction and real-time fluorescence quantitative-polymerase chain reaction.The patients were divided into the low expression group(n=35) and the high expression group(n=85) according to the expression of TYMS mRNA of the patients.The relationships between the expression of TYMS gene and the clinicopathological parameters,the efficacy and prognosis of patients were analyzed.Survival curve was drawn by Kaplan-Meier method and the 3-year survival rate of patients was compared between the two groups.Results The proportion of 3R/3R,2R/2R and 2R/3R genotypes of TYMS in the 120 advanced CRC patients was 70.83%,12.5% and 16.67%,respectively.There was no significant difference in the relative expressions of 2R/2R and 2R/3R genotypes mRNA(P>0.05);the relative expression of 3R/3R genotype mRNA was higher than that of 2R/2R and 2R/3R genotypes(P<0.05).The expression of TYMS was not related to gender,age,histological type,tumor location,differentiation degree and depth of invasion of patients (P>0.05);but it was related to TNM stage and lymph node metastasis of patients (P<0.05).The effective rate of chemotherapy of patients in the high expression group and the low expression group was 62.35% (53/85) and 91.43% (32/35),respectively;the effective rate of chemotherapy of patients in the high expression group was lower than that in the low expression group (χ2=10.732,P<0.05).Logistic analysis showed that the high expression of TYMS,TNM stage Ⅳ and lymph node metastasis were independent risk factors affecting efficacy of advanced CRC patients (OR=2.259,2.484,2.540;P<0.05);and the high expression of TYMS and lymph node metastasis were independent risk factors affecting prognosis of advanced CRC patients (OR=1.371,2.640;P<0.05).The 3-year survival rates of patients in the high expression group and the low expression group were 63.53% (54/85) and 88.57% (31/75),respectively;the 3-year survival curve of patients in the low expression group was significantly higher than that in the high expression group (χ2=7.401,P<0.05).Conclusion The expression of TYMS mRNA is closely related to the sensitivity of FOLFOX4 chemotherapy in patients with advanced CRC.The low expression of TYMS can enhance the sensitivity of FOLFOX4 chemotherapy,and improve the therapeutic effect.

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更新日期/Last Update: 2020-10-05