Abstract
Purpose
The aim of this study was to investigate the association of the thymidylate synthase (TS) and methylenetetrahydrofolate reductase (MTHFR) polymorphisms with the clinical outcomes of gastric cancer patients treated with 5-FU-based adjuvant chemotherapy.
Methods
One-hundred and sixteen patients with gastric cancer were treated with 5-FU-based adjuvant chemotherapy. The TS (a 28-bp tandem repeat polymorphism in the TS enhancer region (TSER) and a 6 bp deletion/insertion polymorphism in the 3′-untranslated region) and MTHFR C677T polymorphisms were determined in blood samples from those patients using PCR and PCR-LDR (ligation detection reaction) method, respectively.
Results
The overall survival (OS) in patients with the TS ins6/ins6 genotype was significantly shorter than those in patients with the del6/del6 (P = 0.017) and ins6/del6 (P = 0.022) genotype. The relapse-free survival (RFS) and OS in patients with the MTHFR C/C genotype were significantly worse than those in patients with the T/T or C/T genotype (P = 0.043 and 0.040, respectively). Cox multivariate analysis also showed that patients with the TS ins6/ins6 genotype have worse OS than patients with the T/T or C/T genotype (HR = 2.437, P = 0.041), and the MTHFR C/C genotype was associated with shorter RFS (HR = 1.723, P = 0.031) and OS (HR = 1.681, P = 0.056). No significant association was found between the TSER polymorphism and the clinical outcomes (P > 0.05).
Conclusion
The polymorphisms of TS 3′-UTR ins6/del6 and MTHFR C677T appear to be potential prognostic factors in gastric cancer patients treated with 5-FU-based adjuvant chemotherapy, which may allow identification of gastric cancer patients who will benefit from 5-FU chemotherapy.
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Acknowledgments
This work was supported in part by a grant from the Scientific and Technologic Bureau of Wuxi (CLZ00612).
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Supplementary Fig. 1 Genotyping results of the TS and MTHFR polymorphisms. A: Electrophoresis results of the TSER and TS 3′-UTR PCR products; B: Sequencing-verified results for the representative genotypes of TSER and TS 3′-UTR polymorphisms; C: Electrophoresis results of PCR-LDR products for MTHFR; D: Sequencing-verified result for the representative PCR products of MTHFR (PDF 220 kb)
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Huang, ZH., Hua, D. & Li, LH. The polymorphisms of TS and MTHFR predict survival of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in Chinese population. Cancer Chemother Pharmacol 63, 911–918 (2009). https://doi.org/10.1007/s00280-008-0815-6
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DOI: https://doi.org/10.1007/s00280-008-0815-6