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目的:探讨胸苷酸合成酶(TS)表达与培美曲塞治疗晚期非小细胞肺癌(NSCLC)疗效的关系。方法:回顾性分析42例接受培美曲塞联合顺铂或卡铂化疗的晚期NSCLC,免疫组化检测肿瘤组织的TS表达,并对化疗疗效进行分析。结果:42例患者中,TS低表达76.2%(32/42),TS高表达23.8%(10/42)。总客观有效率38.1%(16/42),疾病控制率76.2%(32/42);其中TS低表达患者的客观有效率(43.8%,14/32)与TS高表达患者(20.0%,2/10)差异无统计学意义,χ2=1.822,P=0.177;但TS低表达患者的疾病控制率(84.4%,27/32)明显高于TS高表达患者(50.0%,5/10),χ2=4.063,P=0.026。42例患者的中位无疾病进展时间为5.0个月,中位生存时间为12.5个月;其中TS低表达(6.4个月)患者的中位无疾病进展时间较TS高表达(3.8个月)患者长,P=0.000;但中位生存时间(13.0、8.5个月)差异无统计学意义,P=0.079。结论:TS表达水平可能与培美曲塞的疗效相关,可能是预测培美曲塞治疗晚期NSCLC疗效的生物标志之一。
Objective: To investigate the relationship between thymidylate synthase (TS) expression and the efficacy of pemetrexed in the treatment of advanced non-small cell lung cancer (NSCLC). Methods: Forty-two patients with advanced NSCLC treated with pemetrexed plus cisplatin or carboplatin were retrospectively analyzed. The expression of TS was detected by immunohistochemistry and the effect of chemotherapy was analyzed. Results: Among the 42 patients, TS was low expressed in 76.2% (32/42) and TS highly expressed in 23.8% (10/42). The total objective effective rate was 38.1% (16/42) and the disease control rate was 76.2% (32/42). The objective effective rate (43.8%, 14/32) in patients with TS low expression was significantly higher than that in patients with high TS (20.0%, 2 / 10), there was no significant difference between the two groups (χ2 = 1.822, P = 0.177). However, the disease control rate (84.4%, 27/32) in patients with TS low expression was significantly higher than that in TS patients with high expression (50.0%, 5/10) χ2 = 4.063, P = 0.026. The median progression-free time was 5.0 months and the median survival time was 12.5 months in 2 of 52 cases. The median progression-free time of TS low expression (6.4 months) Patients with TS high expression (3.8 months) had long, P = 0.000; however, the median survival time (13.0 and 8.5 months) had no significant difference (P = 0.079). Conclusion: TS expression may be related to the efficacy of pemetrexed, which may be one of the biomarkers for predicting the efficacy of pemetrexed in the treatment of advanced NSCLC.