Ogata Yutaka, Matono Keiko, Mizobe Tomoaki, Ishibashi Nobuya, Mori Shinjiro, Akagi Yoshito, Ikeda Satoru, Ozasa Hiroyuki, Murakami Hidetsugu, Shirouzu Kazuo
Department of Surgery, Kurume University School of Medicine, Asahi-machi, Fukuoka 830-0011, Japan.
Oncol Rep. 2006 May;15(5):1111-6.
The aim of this study was to determine any correlation between the efficacy of post-operative adjuvant chemotherapy using oral fluoropyrimidines and the vascular endothelial growth factor (VEGF) expression in primary colorectal cancer tissues. The data were reviewed retrospectively on 342 patients with colorectal cancer at stage II or III, who underwent potentially curative resection between 1988 and 1998. Of these, 225 received post-operative administration of oral fluoropyrimidines such as UFT and 5'-DFUR, while the other 117 patients underwent surgery alone. Immunostaining for VEGF was performed using colorectal tumours. Overall, VEGF was positively expressed in primary tumour cells in 48% of patients. The disease-free survival rate and the overall survival rate in the chemotherapy group were higher than those in the surgery-alone group, although not significantly. However, the disease-free survival rate and the overall survival rate were similar between the two groups in patients with a tumour positive for VEGF. Multivariate analysis revealed that the VEGF expression was an independent factor for post-operative recurrence, and the VEGF expression and post-operative adjuvant chemotherapy were an independent factor for overall survival, in addition to the lymph node metastasis and the venous invasion. In conclusion, the efficacy of post-operative adjuvant chemotherapy using oral fluoropyrimidines may not be as great for patients with a tumour positive for VEGF having a greater risk of post-operative recurrence. The results support further investigation on efficacy of molecular targeting therapy for VEGF in combination with oral fluoropyrimidines as post-operative adjuvant therapy in colorectal cancer positive for VEGF.
本研究旨在确定口服氟嘧啶类药物进行术后辅助化疗的疗效与原发性结直肠癌组织中血管内皮生长因子（VEGF）表达之间的相关性。回顾性分析了1988年至1998年间接受了可能治愈性切除的342例II期或III期结直肠癌患者的数据。其中，225例接受了口服氟嘧啶类药物（如优福定和去氧氟尿苷）的术后给药，而另外117例患者仅接受了手术。使用结直肠肿瘤进行VEGF免疫染色。总体而言，48%的患者原发性肿瘤细胞中VEGF呈阳性表达。化疗组的无病生存率和总生存率高于单纯手术组，尽管差异不显著。然而，VEGF阳性肿瘤患者的两组无病生存率和总生存率相似。多因素分析显示，VEGF表达是术后复发的独立因素，除淋巴结转移和静脉侵犯外，VEGF表达和术后辅助化疗是总生存的独立因素。总之，对于VEGF阳性、术后复发风险较高的患者，口服氟嘧啶类药物进行术后辅助化疗的疗效可能不太理想。这些结果支持进一步研究VEGF分子靶向治疗联合口服氟嘧啶类药物作为VEGF阳性结直肠癌术后辅助治疗的疗效。
