TS在直肠癌组织中表达及其临床意义.docVIP

TS在直肠癌组织中表达及其临床意义 　　【摘要】 目的 探讨胸苷酸合成酶(TS)在直肠癌组织中的表达及其临床意义。方法 用免疫组化SP法检测48例结肠直肠癌组织中TS的表达,用Kap lan-Meier法分析TS的表达与临床病理特征和预后的相关性。用多因素COX模型分析影响患者预后的相关因素。结果 TS在癌组织中阳性表达率高于正常组织和癌旁组织;中晚期阳性表达率高于早期病例;低分中阳性表达率高于高分化组织;2年复发组中阳性表达率高于非复发组(P0.05)。多因素分析显示TS是影响预后的重要因素。结论 TS可以作为判断直肠癌恶性程度、对5-FU耐药情况以及预测预后的重要参考指标。 　　【关键词】直肠癌; 胸苷酸合成酶;免疫组化 　　 　　Expression of thymidylate synthase in rectal cancer and its clinical significance 　　ZOU Jin-lin,SUN Hua-bin, YING Fang, et al. 　　Department of General Surgery,The Fifth Affiliated Hospital of Sun Yat-Sen University,Guangdong,Zhuhai 519000,China 　　【Abstract】 Objective To investigate Expression of thymidylate synthase(TS) in rectal cancer and its clinical significance.Methods Expression of TS was observed in 48 cases of rectal cancer (RC) tissues using immunohistochemical staining. Kaplan-Meier survival analysis was used to analyze the correlation of the expression of TS with the clinicopathologic parameters and prognosis of RC patients. Multiple COX proportional hazards model analysis was used to analyze the prognostic factors. Results The expression level of TS in RC tissues was higher than normal and RC sideward tissues,and in lower degree of tumor differentiation than in high degree,at early stage cases was higher than at advanced case. The expression level of TS in the cases with recrudescence in 2-year was high than in the cases without recrudescence in 2-year(P0.05).Multiple analysis showed that TS expression was independent prognostic factors for RC. Conclusion The expression of TS is a significant prognostic factors for RC,and can be regarded as a index for estimating the m alignant degree of RC and resistant 5-FU. 　　【Key words】 Rectal cancer;Thymidylate synthase;Immunohistochemistry 　　 　　直肠癌是临床上常见的消化道肿瘤,由于隐蔽于肠道,早期难以发现,多数患者就诊时已经是中晚期病例,化疗是不可缺少的治疗手段之一,而肿瘤对化疗药物的耐药往往是肿瘤复发的重要原因之一。5-FU类药物是结肠直肠癌化疗的基本用药之一。胸苷酸合成酶( thymidylate synthase,TS)是5-FU作用的靶酶,TS的作用是催化脱氧尿嘧啶核苷酸转化为脱氧胸苷酸,它是DNA合成所必需的成分,其结果是破坏了细胞内DNA合成的核苷酸池,影响了DNA的合成,导致肿瘤细胞死亡。本研究目的在于通过检测耐药相关基因TS在直肠癌组织