目的：探讨海南黎族肺腺癌患者癌组织中胸苷酸合酶（ TS） mRNA表达水平对培美曲塞辅助化疗预后的影响。方法选取2008年6月-2009年4月在我院手术治疗的晚期肺腺癌患者52例，采用培美曲塞为主的方案进行辅助化疗。采用反转录聚合酶链反应（ RT-PCR）和相对定量的方法分别检测患者癌组织及癌旁组织中TS mRNA的表达水平，分析TSmRNA表达水平对患者化疗预后的影响。结果52例肺腺癌患者中，35例（67.3%）癌组织TS mRNA表达水平低于其癌旁组织。52例肺腺癌患者癌组织中TS基因 mRNA表达水平相差67倍，以临界值（ cut-off均值）为界，TS mRNA高表达患者29例（55.8%），低表达患者23例（44.2%）。癌组织中TS mRNA低表达组患者的无复发生存率（61.0%）和总生存率（56.5%）均高于高表达组（39.0%和43.5%）（P<0.05）。结果癌组织中TS mRNA低表达的患者更能从培美曲塞为主的辅助化疗方案中受益；检测癌组织中TS mRNA表达水平有助于预测患者对化疗药物的敏感性。%Objective Toinvestigatetheprognosticimpactofthymidylatesynthase(TS)mRNAexpressionlevelin HainanLinationalitylungadenocarcinomapatientstreatedwithpemetrexed.Methods Atotalof52patientswithadvancedlung adenocarcinoma who had surgery in our hospital from June 2008 to April 2009,were selected as study subjects. All patients re-ceived adjuvant chemotherapy,pemetrexed was the main chemotherapeutic drug. RT -PCR and relative quantification method were used to detect the expression levels of cancer tissues and paracancerous tissues. The prognostic impact of TS mRNA expres-sionlevelinpatientswhoreceivedchemotherapywasanalyzed.Results Of52patients,TSmRNAexpressionlevelsofcancer tissues were significantly lower than those of paracancerous tissues in 35 cases(67. 3%). Of 52 patients,the highest TS mRNA expression level was 67 times as much as the lowest TS mRNA expression level of cancer tissues. According to median value of cut-off value,there were 29 patients(55. 8%)with high expression of TS gene mRNA in carcinoma tissue,and there were 23 pa-tients(44. 2%)with low expression. The recurrent-free survival rate(61. 0%)and overall survival rate(56. 5%)of patients in low TS mRNA expression level group were significantly higher than those(39. 0% and 43. 5%) of patients in high TS mRNA expressionlevelgroup,respectively(P<0.05).℅onclusion ThepatientswithlowexpressionlevelofTSmRNAincarcinoma tissue can benefit from adjuvant chemotherapy with pemetrexed. Detection of TS mRNA expression levels in cancer tissues can pre-dict the sensitivity to chemotherapeutic drugs.
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