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一名携带二氢嘧啶脱氢酶(DPYD)、胸苷酸合成酶(TYMS)、亚甲基四氢叶酸还原酶(MTHFR)和二氢叶酸还原酶(DHFR)基因变异的结直肠癌患者在接受基于5-氟尿嘧啶的化疗后疾病早期复发。

Early disease relapse in a patient with colorectal cancer who harbors genetic variants of DPYD, TYMS, MTHFR and DHFR after treatment with 5-fluorouracil-based chemotherapy.

作者信息

Zawiah Mohammed, Yousef Al-Motassem, Kadi Taha, Yousef Mohammed, Majdalawi Khalil, Al-Yacoub Shorouq, Al-Hiary Rasha, Tantawi Dua'a, Mukred Ramzi, Ajaj Abdel Rahman

机构信息

Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.

Oncology Department, Al-Basheer Hospital, Amman, Jordan.

出版信息

Drug Metab Pers Ther. 2018 Dec 19;33(4):201-205. doi: 10.1515/dmpt-2018-0012.

Abstract

Background Early relapse in colorectal cancer (CRC) after curative resection is mainly attributed to the key determinants such as tumor histology, stage, lymphovascular invasion, and the response to chemotherapy. Case presentation Interindividual variability in the efficacy of adjuvant chemotherapy between patients receiving the same treatment may be ascribed to the patients' genetic profile. In this report, we highlight a clinical case of a patient with stage II CRC who relapsed within a short period after starting adjuvant chemotherapy and was later found to have multiple genetic polymorphisms in the DPYD, TYMS, MTHFR, and DHFR genes. Conclusions Based on the clinical data of the patient and the key role of these genes in 5-fluorouracil pathway, we hypothesize that these variants may contribute to the drug response and early relapse in CRC.

摘要

背景 结直肠癌(CRC)根治性切除术后的早期复发主要归因于肿瘤组织学、分期、淋巴管浸润以及对化疗的反应等关键决定因素。病例报告 接受相同治疗的患者之间辅助化疗疗效的个体差异可能归因于患者的基因谱。在本报告中,我们重点介绍了一例II期CRC患者的临床病例,该患者在开始辅助化疗后短期内复发,后来发现其DPYD、TYMS、MTHFR和DHFR基因存在多种基因多态性。结论 根据该患者的临床资料以及这些基因在5-氟尿嘧啶途径中的关键作用,我们推测这些变异可能导致CRC的药物反应和早期复发。

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