目的 探讨老年晚期肺腺癌患者胸苷酸合成酶(TS)基因与培美曲塞疗效的关系.方法 收集37例老年晚期肺腺癌患者,随机分为培美曲塞联合卡铂方案组和紫杉醇联合卡铂方案组；RT-PCR检测肿瘤组织中TS mRNA的表达,Western blotting检测TS蛋白的表达.结果 两组疾病控制率差异无统计学意义.TS mRNA和蛋白的表达与年龄、性别及分期无关.培美曲塞联合卡铂组中获疾病控制者(CR +PR+ SD)的TS mRNA和蛋白表达量为5.08±2.30和4.46±2.22,进展者(PD)为13.66±3.84和12.6±3.92,差异均有统计学意义(P＜0.05).紫杉醇联合卡铂方案组中获疾病控制者与进展者的TSmRNA和蛋白表达差异均无统计学意义(P＞0.05).结论 肺腺癌患者肿瘤组织中TS基因的表达与患者对培美曲塞的敏感性相关,TS基因高表达提示对培美曲塞敏感性降低.%Objective To investigate the expression of thymidylate synthase (TS) in senile patients with advanced pulmonary adenocarcinoma and its relationship with the therapeutic effect of pemetrexed. Methods A total of 37 senile advanced pulmonary adenocarcinoma patients were randomized into pemetrexed plus carboplatin group and paclitaxel plus carboplatin group. RT-PCR was used to examine TS mRNA, and Western blotting was used to analyze TS protein. Results There was no significance in the disease control rate of the two groups. The expression of TS mRNA and protein was not related to age, gender and clinical stage. In pemetrexed plus carboplatin group, the TS mRNA of response (CR + PR + SD) and no response group (PD) was 5.08 ± 2. 30 and 13.66 ± 3. 84 (P < 0.05). The expression level of TS protein of response and no response group was 4.46 ± 2.22 and 12.96 ± 3.92 (P < 0.05). However, there was no significant difference between these patients in paclitaxel plus carboplatin group neither in TS mRNA nor in TS protein (P > 0. 05). Conclusion The expression of TS gene in pulmonary adenocarcinoma biopsy is related to the sensitivity to pemetrexed. Patients with high expression of TS gene will have poor response to pemetrexed.
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