肿瘤5-氟尿嘧啶相关mRNA表达及口服氟嘧啶在结直肠癌辅助化疗中的疗效
Tumor 5-FU-related mRNA Expression and Efficacy of Oral Fluoropyrimidines in Adjuvant Chemotherapy of Colorectal Cancer.
作者信息
Koda Keiji, Miyauchi Hideaki, Kosugi Chihiro, Kaiho Takashi, Takiguchi Nobuhiro, Kobayashi Susumu, Maruyama Takashi, Matsubara Hisahiro
机构信息
Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
Department of Academic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
出版信息
Anticancer Res. 2016 Oct;36(10):5325-5331. doi: 10.21873/anticanres.11105.
BACKGROUND
It has not been elucidated whether the clinical efficacy of oral fluoropyrimidines for adjuvant chemotherapy of colorectal cancer varies with tumor biological characteristics.
PATIENTS AND METHODS
A multicenter randomized trial was performed comparing oral tegafur/gimeracil/oteracil (S-1) and uracil-tegafur/ leucovorin (UFT/LV) as adjuvant therapy for stage III colorectal cancer. Postoperative survival was compared based on the 5-FU-related mRNA levels in cancer tissues.
RESULTS
Among patients with tumor expressing dihydropyrimidine dehydrogenase (DPD) mRNA within the 66.7th percentile (lower 2/3) of all cases, overall survival (OS) was significantly better in the S-1 than in the UFT/LV group. In the S-1 group, patients with low DPD-expressing tumors had significantly better OS than those with highly expressing tumors. Patients with low thymidine synthase (TS)-expressing tumors had significantly better OS than those with highly expressing tumors.
CONCLUSION
The efficacy of oral fluoropyrimidines as adjuvant chemotherapy for colorectal cancer may be influenced by the level of 5-FU-related mRNA in cancer tissues.
背景
口服氟嘧啶类药物用于结直肠癌辅助化疗的临床疗效是否因肿瘤生物学特征而异尚未阐明。
患者与方法
开展一项多中心随机试验，比较口服替吉奥（S-1）与替加氟尿嘧啶/亚叶酸钙（UFT/LV）作为Ⅲ期结直肠癌辅助治疗的效果。根据癌组织中与5-氟尿嘧啶相关的mRNA水平比较术后生存率。
结果
在肿瘤组织二氢嘧啶脱氢酶（DPD）mRNA表达处于所有病例第66.7百分位数（较低的2/3）以内的患者中，S-1组的总生存期（OS）显著优于UFT/LV组。在S-1组中，DPD表达低的肿瘤患者的OS显著优于高表达肿瘤患者。胸苷合酶（TS）表达低的肿瘤患者的OS显著优于高表达肿瘤患者。
结论
口服氟嘧啶类药物作为结直肠癌辅助化疗的疗效可能受癌组织中5-氟尿嘧啶相关mRNA水平的影响。
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