Nakagawa Tatsuo, Tanaka Fumihiro, Takata Tetsuya, Matsuoka Katsunari, Miyahara Ryo, Otake Yosuke, Yanagihara Kazuhiro, Fukushimab Masakazu, Wada Hiromi
Department of Thoracic Surgery, Faculty of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.
J Surg Oncol. 2002 Oct;81(2):87-92. doi: 10.1002/jso.10137.
Dihydropyrimidine dehydrogenase (DPD) activity in tumor cells has been suggested to be one of the factors determining the effectiveness of 5-fluorouracil (5-FU). In the present study, we analyzed DPD expression in tumors and investigated retrospectively the relationship between the efficacy of UFT (Tegafur + Uracil) as adjuvant chemotherapy and DPD expression in nonsmall-cell lung cancer (NSCLC).
DPD expression of 166 resected p-stage I NSCLC was examined immunohistochemically. Patients who were administered UFT alone as adjuvant therapy comprised the UFT group (n = 54), and those who underwent only surgery comprised the control group (n = 112). DPD expression was categorized as either high or low, according to intensity of staining.
DPD expression was high in 98 patients (59.0%) and low in 68 patients (41.0%). Patients with low-DPD tumors who were administered UFT had a significantly better prognosis than those who did not receive adjuvant treatment (P = 0.021). No significant difference was found between the two groups of patients with high-DPD tumors (P = 0.598).
DPD expression may predict the efficacy of UFT after surgery for p-stage I NSCLC. A prospective study is needed to confirm the role of DPD expression as a predictor of UFT efficacy.
肿瘤细胞中的二氢嘧啶脱氢酶（DPD）活性被认为是决定5-氟尿嘧啶（5-FU）疗效的因素之一。在本研究中，我们分析了肿瘤中DPD的表达情况，并回顾性研究了优福定（替加氟+尿嘧啶）作为辅助化疗药物在非小细胞肺癌（NSCLC）中的疗效与DPD表达之间的关系。
采用免疫组织化学方法检测166例I期p-NSCLC手术切除标本中DPD的表达。仅接受优福定辅助治疗的患者组成优福定组（n = 54），仅接受手术治疗的患者组成对照组（n = 112）。根据染色强度将DPD表达分为高表达和低表达。
98例患者（59.0%）DPD高表达，68例患者（41.0%）DPD低表达。接受优福定治疗的低DPD肿瘤患者的预后明显好于未接受辅助治疗的患者（P = 0.021）。高DPD肿瘤的两组患者之间未发现显著差异（P = 0.598）。
DPD表达可能预测I期p-NSCLC手术后优福定的疗效。需要进行前瞻性研究以证实DPD表达作为优福定疗效预测指标的作用。
