Zhang Cong, Liu Hongpeng, Ma Bin, Song Yongxi, Gao Peng, Xu Yingying, Yu Dehao, Wang Zhenning
Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
Department of Breast Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
Dis Markers. 2017;2017:9202676. doi: 10.1155/2017/9202676. Epub 2017 Jan 31.
The potential impact that the intratumoral expression level of dihydropyrimidine dehydrogenase (DPD) has on chemotherapy sensitivity and long-term survival for gastric cancer (GC) patients remains controversial; therefore, this study seeks to clarify this issue. Our meta-analysis was performed using Review Manager (RevMan) 5.3 software. In vitro drug sensitivity tests, correlation coefficients between sensitivity to 5-fluorouracil (5-FU), and expression levels of intratumoral DPD were used as effective indexes to analyse. Overall survival (OS) and progression-free survival (PFS) were used as endpoints for patient outcome, and hazard ratios (HRs) and 95% confidence intervals (CIs) were noted as measures of effect. There were 15 eligible studies including 1805 patients for the final analysis. The analysis revealed a statistically significant difference between the expression level of intratumoral DPD activity, DPD mRNA levels, and sensitivity to 5-FU in GC patients, with high expression levels of intratumoral DPD resulting in low sensitivity to 5-FU. However, no matter what therapeutic regimens were used, there was no significant difference for patient outcomes between high and low DPD expression groups, either in OS or in PFS. In conclusion, high levels of intratumoral DPD expression have a negative impact on sensitivity to 5-FU in GC patients, but no prognostic value for long-term survival was uncovered.
二氢嘧啶脱氢酶（DPD）的肿瘤内表达水平对胃癌（GC）患者化疗敏感性和长期生存的潜在影响仍存在争议；因此，本研究旨在阐明这一问题。我们使用Review Manager（RevMan）5.3软件进行了荟萃分析。体外药物敏感性试验、对5-氟尿嘧啶（5-FU）的敏感性与肿瘤内DPD表达水平之间的相关系数被用作有效指标进行分析。总生存期（OS）和无进展生存期（PFS）被用作患者预后的终点指标，风险比（HRs）和95%置信区间（CIs）被记录为效应量度。最终分析纳入了15项符合条件的研究，共1805例患者。分析显示，GC患者肿瘤内DPD活性表达水平、DPD mRNA水平与对5-FU的敏感性之间存在统计学显著差异，肿瘤内DPD高表达导致对5-FU敏感性低。然而，无论采用何种治疗方案，DPD高表达组和低表达组患者的OS或PFS预后均无显著差异。总之，肿瘤内DPD高表达对GC患者对5-FU的敏感性有负面影响，但未发现其对长期生存有预后价值。
