TTF-1及TS在肺腺癌中的表达及与培美曲塞化疗疗效相关性分析 Relationship between Expression of TTF-1, TS and Chemotherapy Effect of Pemetrexed in Advanced Lung Adenocarcinoma

目的：探讨晚期肺腺癌中TTF-1和TS的表达与培美曲塞化疗疗效的关系。方法：回顾性分析80例接受培美曲塞化疗的晚期肺腺癌患者的临床病理资料。免疫组织化学法检测肿瘤标本TTF-1和TS蛋白的表达，并对疗效进行分析。结果：TTF-1阳性表达率为71.25% (57/80)，TS阳性表达率为22.50% (18/80)。TTF-1和TS在肺癌中的表达呈负相关性(r = −0.356，P = 0.002)。化疗有效率(CR + PR)为46.25%，TTF-1(+)患者有效率(64.91%)显著高于TTF-1(−)患者(39.13%)，差异有显著性(P < 0.05)。TS(+)患者有效率(27.78%)显著低于TS(−)患者51.61%，差异有显著性(P < 0.05)。联合检测显示：TTF-1(−)且TS(+)组有效率为28.57%，中位无疾病进展时间为3.9个月，1年生存率为28.6%，TTF-1(+)且TS(−)组有效率为81.13%，中位无疾病进展时间为7.4个月，1年生存率为69.8%，差异均有显著性(P < 0.05)。结论: 联合检测TTF-1和TS的表达可作为培美曲塞化疗方案治疗晚期肺腺癌的疗效预测指标之一。 Objective: To investigate the relationship between expression of TTF-1, TS and chemotherapy effect of pemetrexed in advanced lung adenocarcinoma. Methods: Eighty patients with advanced lung adenocarcinoma treating by pemetrexed were enrolled in this study and their tumor samples were collected retrospectively for analysis. The expression of TTF-1, TS protein in tumor samples was de-tected by the immunohistochemical method. The data of therapeutical effect and toxicity were col-lected and analyzed. Results: The TTF-1 positive staining accounted for 71.25% (57/80). The TS positive staining accounted for 22.50% (18/80). TTF-1 and TS expression in lung cancer tissues had negative correlation (r = −0.356, P = 0.002). The response rate (CR + PR) was 46.25%. The efficiency of patients with over-expression of TTF-1 (64.91%) was significant higher than patients with low-expression of TTF-1 (39.13%) (P < 0.05). The efficiency of patients with over-expression of TS (27.78%) was significant lower than patients with low-expression of TS (51.61%) (P < 0.05). The ef-ficiency, median progress time and 1-survival rate of patients with over-expression TS and low-expression of TTF-1 (28.57%, 3.9 months, 28.6%) were all significant lower than patients with over-expression TTF-1 and low-expression of TS (81.13%, 7.4 months, 69.8%) (P < 0.05). Conclu-sions: The expression of TTF-1 and TS is associated with chemotherapy effect of pemetrexed in ad-vanced lung adenocarcinoma and can be used to detect the sensitivity.