Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Lung Cancer. 2011 Jun;72(3):360-4. doi: 10.1016/j.lungcan.2010.08.024. Epub 2010 Oct 22.
Not all patients with lung cancer require postoperative adjuvant chemotherapy after a complete resection. However, no useful markers for either selecting appropriate candidates or for predicting clinical recurrence exist.
Tumor specimens were collected from 183 consecutive patients who underwent a complete resection for lung adenocarcinoma from 2003 to 2007 in our department. We analyzed the thymidylate synthase (TS) and dihydrofolate reductase (DHFR) expressions in the primary lung adenocarcinoma by immunohistochemisty.
The strong expression of TS and DHFR was identified in 39 (21.3%) and 120 (65.6%) patients, respectively. The strong TS expression was identified in 11 (39.3%) of 28 patients and 28 (18.1%) of 155 patients in patients with and without recurrence, respectively (p=0.012). The strong DHFR expression was also identified in 23 (82.1%) and 97 (62.6%) of the patients with and without recurrence, respectively (p=0.045). Logistic regression models indicated the strong TS expression to be an independent factor for tumor recurrence. The strong TS and DHFR expression was associated with a poorer disease-free survival (DFS) according to the survival analysis. A multivariate analysis demonstrated the strong TS expression to be independently associated with an increased risk for poor DFS.
The strong TS expression may be a useful marker for predicting postoperative recurrence in patients with lung adenocarcinoma following surgery.
并非所有肺癌患者在完全切除术后都需要接受辅助化疗。但是，目前尚无有用的标志物来选择合适的患者或预测临床复发。
从 2003 年至 2007 年，我们科室对 183 例连续的肺腺癌完全切除患者的肿瘤标本进行了收集。我们采用免疫组化方法分析了原发性肺腺癌中胸苷酸合成酶（TS）和二氢叶酸还原酶（DHFR）的表达。
分别有 39 例（21.3%）和 120 例（65.6%）患者的 TS 和 DHFR 表达较强。在有和无复发的患者中，强 TS 表达分别在 28 例（39.3%）和 155 例（18.1%）患者中发现（p=0.012）。强 DHFR 表达也分别在 23 例（82.1%）和 97 例（62.6%）患者中发现（p=0.045）。Logistic 回归模型表明，强 TS 表达是肿瘤复发的独立因素。生存分析表明，强 TS 和 DHFR 表达与无病生存（DFS）较差相关。多变量分析表明，强 TS 表达与较差的 DFS 风险增加独立相关。
强 TS 表达可能是预测肺腺癌患者手术后复发的有用标志物。
