胸苷合成酶表达在培美曲塞治疗晚期卵巢癌患者效果评估中的意义
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摘要
目的探讨胸苷酸合成酶(TS)表达在培美曲塞治疗晚期复发卵巢癌患者效果评估中的意义。方法回顾性分析2010年7月~2014年7月我院80例接受培美曲塞联合奈达铂化疗的晚期复发卵巢癌患者,其中实验组为40例经免疫组化检测TS表达阴性的患者,对照组40例为未经TS酶检测,分析疗效。结果实验组:完全缓解(CR)2例,部分缓解(PR)21例,稳定(SD)8例,进展(PD)9例,对照组:CR 1例,PR 13例,SD 7例,PD 19例。实验组的总有效率、疾病控制率和1年生存率分别为57.5%、77.5%、60.0%,对照组分别是35.0%、52.5%、37.5%,两组差异有统计学意义(P<0.05)。结论 TS可能成为预测晚期卵巢癌患者对培美曲塞敏感性的指标,TS表达阴性卵巢癌患者可能从含培美曲塞的化疗方案中获益。
Objective To evaluate the significance of the thymidylate synthase(TS) expression in therapeutic effect evaluation of Pemetrexed in patients with advanced ovarion cancer.Methods Eighty patients with advanced recurrent ovarian cancer from July 2010 to July 2014 treated in our hospital were analyzed retrospectively,all of them were treated by Pemetrexed combined with Nedaplatin,the experimental group had 40 cases,their tumor tissue were detected by immunohistochemistry with TS negative expression,the control groups of 40 cases with unknown TS expression.The therapeutic effect was analyzed.Results In experimental group,there were 2 cases achieved complete responses(CR) of the 40 cases,21 cases achieved partial response(PR),8 cases achieved stable disease(SD) and 9 patients with progressive disease(PD),while in observation group,there was 1 case achieved CR of the 40 cases,13 cases achieved PR,7 cases achieved SD and19 patients with PD,while in experimental group,the overall response rate, the disease control rate and one year survival rate were 57.5%,77.5% and 60.0% respectively,in observation group,it was 35.0%,52.5%,37.5% respectively,and there was a statistical difference between two groups(P<0.05).Conclusion TS expression may serve as an indicator to predict the sensitivity of chemosensitivity to Pemetrexed in patients with advanced ovarian cancer, the negative expression of TS can benefit from chemotherapy with Pemetrexed.
Objective To evaluate the significance of the thymidylate synthase(TS) expression in therapeutic effect evaluation of Pemetrexed in patients with advanced ovarion cancer.Methods Eighty patients with advanced recurrent ovarian cancer from July 2010 to July 2014 treated in our hospital were analyzed retrospectively,all of them were treated by Pemetrexed combined with Nedaplatin,the experimental group had 40 cases,their tumor tissue were detected by immunohistochemistry with TS negative expression,the control groups of 40 cases with unknown TS expression.The therapeutic effect was analyzed.Results In experimental group,there were 2 cases achieved complete responses(CR) of the 40 cases,21 cases achieved partial response(PR),8 cases achieved stable disease(SD) and 9 patients with progressive disease(PD),while in observation group,there was 1 case achieved CR of the 40 cases,13 cases achieved PR,7 cases achieved SD and19 patients with PD,while in experimental group,the overall response rate, the disease control rate and one year survival rate were 57.5%,77.5% and 60.0% respectively,in observation group,it was 35.0%,52.5%,37.5% respectively,and there was a statistical difference between two groups(P<0.05).Conclusion TS expression may serve as an indicator to predict the sensitivity of chemosensitivity to Pemetrexed in patients with advanced ovarian cancer, the negative expression of TS can benefit from chemotherapy with Pemetrexed.
引文
[1]Jayson GC,Kohn EC,Kitchener HC,et al.Ovarian cancer[J].Lancet,2014,384(9951):1376-1388.
[2]刘德林,孙蔚莉,武渊.培美曲塞联合洛铂治疗多线化疗失败的晚期乳腺癌临床观察[J].江苏医药,2012,38(24):3006-3007.
[3]Nicolson MC,Fennell DA,Ferry D,et al.Thymidylate synthase expression and outcome of patients receiving pemetrexed for advanced nonsquamous non-small-cell lung cancer in a prospective blinded assessment phaseⅡclinical trial[J].J Thorac Oncol,2013,8(7):930-939.
[4]田丹,王军,程越,等.TS蛋白表达在培美曲塞治疗晚期肺腺癌患者疗效的意义[J].广州医科大学学报,2015,43(2):94-96,100.
[5]程婷婷,杨谨.晚期非小细胞肺癌维持治疗的研究进展[J].中华肿瘤防治杂志,2011,18(20):1651-1655.
[6]邓燕明,梁剑苗,冯卫能,等.非小细胞肺癌组织TS表达与培美曲塞治疗疗效相关性的研究[J].中华肿瘤防治杂志,2012,19(21):1636-1639.
[7]Bookman MA.First-line chemotherapy in epithelial ovarian cancer[J].Clin Obstet Gynecol,2012,55(1):96-113.
[8]Taylor C,Mannion D,Miranda F,et al.Loss of PFKFB4 induces cell death in mitotically arrested ovarian cancer cells[J].Oncotarget,2017.[Epub ahead of print]
[9]Egloff H,Jatoi A.Pemetrexed for ovarian cancer:a systematic review of the published literature and a consecutive series of patients treated in a nonclinical trial setting[J].Case Rep Oncol,2014,7(2):541-549.
[10]傅亚均,曾雪影,王以容,等.洛铂联合培美曲塞或吉西他滨对复发性晚期卵巢癌的近期疗效比较[J].西南国防医药,2014,24(1):53-56.
[11]Sun JM,Ahn JS,Jung SH,et al.Pemetrexed plus cisplatin versus gemcitabine plus cisplatin according to thymidylate synthase expression in nonsquamous non-small-cell lung cancer:a biomarker-stratified randomized phaseⅡtrial[J].J Clin Oncol,2015,33(22):2450.
[12]禚守荣,秦春新,矫璐宇,等.晚期乳腺癌胸苷酸合成酶m RNA表达与培美曲塞疗效的相关性研究[J].中国药房,2015,26(20),2821-2823.
[13]王玮,孙文辉,燕海姣,等.培美曲塞联合卡铂结合腹腔内温热灌注顺铂治疗复发性卵巢癌的疗效[J].江苏医药,2015,41(14):1703-1704.
[14]黄汉生.培美曲塞联合顺铂治疗晚期卵巢癌的临床研究[J].实用临床医药杂志,2012,16(7),91-92,97.
[15]陆筱灵,卢玮冬,许震,等.培美曲塞联合奈达铂方案二线治疗晚期非小细胞肺癌的疗效观察[J].癌症进展,2012,10(4):415-418.
[16]黄婧,周月华.紫杉醇联合顺铂或卡铂治疗晚期卵巢癌的疗效观察[J].医学临床研究,2013,30(1):47-49.
[17]Zhang F,Wang Y,Wang ZQ,et al.Efficacy and safety of cisplatin-based versus nedaplatin-based regimens for the treatment of metastatic/recurrent and advanced esophageal squamous cell carcinoma:a systematic review and metaanalysis[J].Dis Esophagus,2016.[Epub ahead of print]
[2]刘德林,孙蔚莉,武渊.培美曲塞联合洛铂治疗多线化疗失败的晚期乳腺癌临床观察[J].江苏医药,2012,38(24):3006-3007.
[3]Nicolson MC,Fennell DA,Ferry D,et al.Thymidylate synthase expression and outcome of patients receiving pemetrexed for advanced nonsquamous non-small-cell lung cancer in a prospective blinded assessment phaseⅡclinical trial[J].J Thorac Oncol,2013,8(7):930-939.
[4]田丹,王军,程越,等.TS蛋白表达在培美曲塞治疗晚期肺腺癌患者疗效的意义[J].广州医科大学学报,2015,43(2):94-96,100.
[5]程婷婷,杨谨.晚期非小细胞肺癌维持治疗的研究进展[J].中华肿瘤防治杂志,2011,18(20):1651-1655.
[6]邓燕明,梁剑苗,冯卫能,等.非小细胞肺癌组织TS表达与培美曲塞治疗疗效相关性的研究[J].中华肿瘤防治杂志,2012,19(21):1636-1639.
[7]Bookman MA.First-line chemotherapy in epithelial ovarian cancer[J].Clin Obstet Gynecol,2012,55(1):96-113.
[8]Taylor C,Mannion D,Miranda F,et al.Loss of PFKFB4 induces cell death in mitotically arrested ovarian cancer cells[J].Oncotarget,2017.[Epub ahead of print]
[9]Egloff H,Jatoi A.Pemetrexed for ovarian cancer:a systematic review of the published literature and a consecutive series of patients treated in a nonclinical trial setting[J].Case Rep Oncol,2014,7(2):541-549.
[10]傅亚均,曾雪影,王以容,等.洛铂联合培美曲塞或吉西他滨对复发性晚期卵巢癌的近期疗效比较[J].西南国防医药,2014,24(1):53-56.
[11]Sun JM,Ahn JS,Jung SH,et al.Pemetrexed plus cisplatin versus gemcitabine plus cisplatin according to thymidylate synthase expression in nonsquamous non-small-cell lung cancer:a biomarker-stratified randomized phaseⅡtrial[J].J Clin Oncol,2015,33(22):2450.
[12]禚守荣,秦春新,矫璐宇,等.晚期乳腺癌胸苷酸合成酶m RNA表达与培美曲塞疗效的相关性研究[J].中国药房,2015,26(20),2821-2823.
[13]王玮,孙文辉,燕海姣,等.培美曲塞联合卡铂结合腹腔内温热灌注顺铂治疗复发性卵巢癌的疗效[J].江苏医药,2015,41(14):1703-1704.
[14]黄汉生.培美曲塞联合顺铂治疗晚期卵巢癌的临床研究[J].实用临床医药杂志,2012,16(7),91-92,97.
[15]陆筱灵,卢玮冬,许震,等.培美曲塞联合奈达铂方案二线治疗晚期非小细胞肺癌的疗效观察[J].癌症进展,2012,10(4):415-418.
[16]黄婧,周月华.紫杉醇联合顺铂或卡铂治疗晚期卵巢癌的疗效观察[J].医学临床研究,2013,30(1):47-49.
[17]Zhang F,Wang Y,Wang ZQ,et al.Efficacy and safety of cisplatin-based versus nedaplatin-based regimens for the treatment of metastatic/recurrent and advanced esophageal squamous cell carcinoma:a systematic review and metaanalysis[J].Dis Esophagus,2016.[Epub ahead of print]