Li Yongnan, Li Xiaoxia, Dai Haiping, Sun Xiaodong, Li Jinhua, Yang Fenghua, Gu Hongmei, Yang Yong, Jin Zaishun, Chu Yanhui, Jin Xiudong, Kakehi Yoshiyuki, Wu Xiuxian
Department of Preventive Medicine, Mudanjiang Medical College, Mudanjiang, China.
BJU Int. 2009 Feb;103(4):547-52. doi: 10.1111/j.1464-410X.2008.08099.x. Epub 2008 Oct 16.
To investigate the expression of thymidylate synthase (TS), a key enzyme in DNA synthesis that is over-expressed in several cancer cells, in bladder cancer and its association with patient prognosis and the response to adjuvant therapy.
In all, 67 bladder tissue specimens were obtained from patients who had undergone transurethral resection (TUR). TS expression in bladder cancer and normal bladder tissue was analysed by immunohistochemistry.
Of the 67 bladder tissue specimens, 47 (70%) and 10 (15%) had positive expression for TS in cancer and normal tissues, respectively. TS expression was greater in patients with Grade 3 (16/17, 94%) than in Grade 1 and 2 (31/50, 64%; P = 0.002). It was also greater in Stage T1 (14/14) than in Stage Ta (33/53, 62%; P = 0.001). Furthermore, patients with negative TS expression had a longer postoperative recurrence-free survival (RFS) than those with positive expression during the 5 year follow-up (P = 0.028). In the patients with positive TS-expressing tumours, adjuvant therapy significantly improved RFS (P < 0.001).
High TS expression might be a marker of poor prognosis for patients with bladder cancer. In addition, patients with high TS expression might also be benefit from adjuvant therapy.
研究胸苷酸合成酶（TS）在膀胱癌中的表达情况，TS是DNA合成中的关键酶，在多种癌细胞中过度表达，并探讨其与患者预后及辅助治疗反应的关系。
共收集67例经尿道膀胱肿瘤切除术（TUR）患者的膀胱组织标本。采用免疫组化法分析膀胱癌组织和正常膀胱组织中TS的表达。
67例膀胱组织标本中，47例（70%）癌组织TS表达阳性，10例（15%）正常组织TS表达阳性。TS在3级患者（16/17，94%）中的表达高于1级和2级患者（31/50，64%；P = 0.002）。在T1期患者中TS表达也高于Ta期患者（14/14对比33/53，62%；P = 0.001）。此外，在5年随访期间，TS表达阴性的患者术后无复发生存期（RFS）长于TS表达阳性的患者（P = 0.028）。在TS表达阳性肿瘤患者中，辅助治疗显著改善了RFS（P < 0.001）。
TS高表达可能是膀胱癌患者预后不良的一个标志物。此外，TS高表达的患者可能也能从辅助治疗中获益。
