DNA修复基因XRCC1基因多态性与乳腺癌临床病理参数的相关性

目的：研究XRCC1基因Arg194Trp和Arg399GIn多态性与中国女性乳腺癌临床病理参数的关系。探讨其在乳腺癌预后中的潜在意义。方法：采用聚合酶链反应-限制性片段长度多态性（PCR—RFLP）方法，对250例原发性乳腺癌患者进行XRCC1基因Arg194Trp、Arg399GIn多态性分析，用Pearson X^2检验分析基因型与临床病理特征的关系。结果：XRCC1基因Arg194Trp和Arg399GIn多态性与乳腺癌患者的月经状态、肿瘤大小、腋窝淋巴结转移、TNM分期、雌激素受体均无显著相关性（P〉0．05）。但该多态位点与乳腺癌患者的孕激素受体（PR）状态和C—erbB2蛋白表达显著相关。携带194纯合突变型的患者PR阴性率（81．0％）显著高于携带194野生型和杂合型患者（55．4％），（P=0．034）；携带399纯舍突变型的患者C—erbB2蛋白表达阳性率（61．1％）显著高于携带399野生型和杂合型的患者（29．3％），（P=-0．006）。结论：PR阴性和（或）C—erbB2高表达的乳腺癌患者常提示预后不良。XRCC1基因多态性与PR阴性或C—erbB2高表达显著相关，提示携带XRCC1纯合突变（194或399）乳腺癌患者可能预后不良。     

XRCC1基因多态性与卵巢癌对铂类药物化疗敏感性的相关性研究

目的 探讨X线修复交叉互补基因1（XRCC1）Arg194Trp和Arg399Gln位点多态性与卵巢癌对铂类药物化疗敏感性之间的关系。方法 选取82例首次术后以铂类为基础化疗达6个周期的卵巢癌患者,采用聚合酶链反应 限制性片段长度多态性分析（PCR RFLP）检测外周血XRCC1 Arg194Trp和Arg399Gln位点的基因型,分别比较两个位点的不同基因型与化疗敏感性及两个位点之间的关系。结果 XRCC1 Arg194Trp存在3个基因型,即Arg／Arg、Arg／Trp、Trp／Trp,基因分布频率分别为47.6％、43.9％、8.5％;XRCC1 Arg399Gln亦存在3个基因型,即Arg／Arg、Arg／Gln、Gln／Gln,基因分布频率分别为25.6％、40.2％、34.1％。XRCC1 Arg399Gln 的不同基因型在FIGO分期和年龄分组中的差异均有统计学意义（P＜0.05）。化疗敏感组与不敏感组两个位点多态性基因型之间的差异均有统计学意义（P＜0.05）。XRCC1 Arg194Trp的Trp／Trp和Arg 399Gln的Gln/Gln基因型比Arg／Arg基因型更易对铂类药物产生耐药性,比值比分别增加至13.50倍（95％CI：1.461～124.739）和7.65倍（95％CI：2.012～29.088）。同时携带Arg194Trp Arg／Trp和Arg399Gln Gln／Gln基因型的患者对化疗不敏感率高达84.62％（OR=22.00,95％CI：2.534～190.998;P＜0.05）。结论 XRCC1 Arg194Trp和Arg399Gln位点基因多态性与卵巢癌对铂类药物的化疗敏感性相关,并且两位点之间存在联合效应。     

BER通路中XRCC1多位点单核苷酸多态性与新疆不同民族喉癌易感性相关性研究

背景与目的:影响肿瘤遗传易感性的修复基因主要存在修复通路碱基切除修复(base excision repair,BER)途径,而X射线交错互补修复基因1(X-ray repair cross complementing group 1,XRCC1)是BER通路中的核心基因。近几年,国内外开展了许多有关基因多态性和喉癌易感性的研究。探讨BER通路DNA修复基因XRCC1多位点单核甘酸多态性与新疆不同民族喉癌易感性关系。方法:采用患者组与对照组的研究方法,选择58例喉癌(经病理证实为鳞状细胞癌)患者和120名体检正常的健康人对照,应用Multiplex SNa Pshot技术检测DNA碱基切除修复基因XRCC1的Gln632Gln(rs3547)、Arg399Gln(rs25487)、Arg280His(rs25489)、Arg194Trp(rs1799782)位点单核苷酸多态在患者组和正常对照组中的分布情况。结果:喉癌患者组中XRCC1Arg280His(rs25489)C/T(杂合型)及T/T(突变型)基因型的比例与对照组比较差异无统计学意义(P>0.05)。喉癌患者组中XRCC1的其余3个位点Gln632Gln(rs3547)C/T(杂合型)及T/T(突变型)基因型、Arg399Gln(rs25487)C/T(杂合型)及T/T(突变型)基因型、Arg194Trp(rs1799782)G/A(杂合型)及A/A(突变型)基因型的比例明显高于对照组(P<0.01)。其中汉、维、哈3个民族患者组Gln632Gln(rs3547)C/T(杂合型)及T/T(突变型)基因型、Arg399Gln(rs25487)C/T(杂合型)及T/T(突变型)基因型、Arg194Trp(rs1799782)G/A(杂合型)及A/A(突变型)基因型比例显著高于对照组(P<0.05),携带(rs3547)C/T及T/T基因型、(rs25487)C/T及T/T基因型、(rs1799782)G/A及A/A基因型个体较携带XRCC1(rs3547)C/C基因型、(rs25487)C/C基因型、(rs1799782)G/G基因型的个体患喉鳞状细胞癌的风险升高了分别为0.96倍、1.74倍、1.39倍;1.47倍、1.32倍、0.77倍,1.49倍、1.51倍、1.56倍。结论:汉、维、哈3个民族的XRCC1 Gln632Gln、Arg399Gln、Arg280His、Arg194Trp位点的单核苷酸多态性可能与喉癌遗传性有关联且有差异,XRCC1基因中的Gln632Gln、Arg399Gln、Arg194Trp位点的突变将导致喉癌的发病风险升高。而XRCC1基因中的Arg280His位点突变与喉癌发病的差异无统计学意义,可能该位点的突变与喉癌发病无关。     

XRCC1和XRCC3单核苷酸多态性与晚期非小细胞肺癌铂类药物化疗疗效的相关性

背景与目的 DNA修复基因多态性预测铂类药物化疗敏感性对非小细胞肺癌(non-small cell lung cancer,NSCLC)个体化治疗具有重要意义.本研究旨在探讨X线修复交错互补基因1(X-ray repair cross complementing gene 1,XRCC1)和X线修复交错互补基因3(X-ray repair cross complementing gene 3,XRCC3)单核苷酸多态性与晚期NSCLC患者对铂类药物化疗疗效的关系.方法 采用PCR-RFLP方法检测130例以含铂方案化疗的晚期NSCLC患者外周血DNA中XRCC1 Arg194 Trp、Arg399 Gln和XRCC3 Thr241 Met基因多态性,分析其基因型与化疗疗效的关系.结果 130例晚期NSCLC患者采用含铂方案化疗2个周期后,化疗总有效率为33.8％.XRCC1 194和399基因多态性与铂类药物化疗敏感性相关,而XRCC3 241基因多态性与化疗敏感性无关(P=0.145).携带至少1个XRCC1 194 Trp等位基因者化疗有效率至少是携带Arg/Arg基因型患者的2.5倍(42.1％vs22.2％,OR=2.545,95％CI:1.159-5.590,P=0.020).携带XRCC1399 Arg/Arg基因型者的化疗有效率为45.5％,明显高于携带至少1个Gln等位基因者(21.9％)(OR=0.336,95％CI:0.156-0.722,P=0.005).XRCC1 194和399基因多态性之间存在联合作用,同时携带至少1个XRCC1 194 Trp等位基因和399 Arg/Arg基因型者的化疗有效率明显高于同时携带194 Arg/Arg和399 Arg/Gln基因型者(44.4％ vs 18.8％,OR=3.467,95％CI:1.223-9.782,P=0.019).XRCC1和XRCC3基因多态性在化疗敏感性方面存在一定的联合作用,携带至少1个XRCC1 194 Trp等位基因和399 Arg/Arg野生型基因同时又携带XRCC3 241 Thr/Met基因型者的化疗有效率明显高于其它基因型携带者.结论 XRCC1和XRCC3的多态联合可能与晚期NSCLC患者对铂类药物化疗疗效具有相关性.     

XRCC1单核苷酸多态性预测晚期NSCLC铂类药物化疗的敏感性

目的研究XRCC1单核苷酸多态性与晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)对以顺铂(cisplatin,DDP)或卡铂(carboplatin,CBP)为基础药物的化疗敏感性的关系。方法经病理学确诊的晚期NSCLC患者97例,采用DDP或CBP为基础药物的方案化疗,3个周期后进行疗效评价。以聚合酶链反应(PCR)结合限制性片段长度多态性(RFLP)检测XRCC1Arg194Trp和Arg399Gln基因型,并比较基因型与化疗敏感性的关系。结果(1)携带XRCC1194Arg/Trp的患者有效率高于携带Arg/Arg、Trp/Trp基因型的患者(P<0.05);携带至少一个Trp等位基因基因型患者的化疗敏感性是携带Arg/Arg基因型的3.4倍(OR=3.39,95%,CI=1.32~8.70,P<0.05)。(2)携带XRCC1399Arg/Arg、Arg/Gln、Gln/Gln基因型患者的有效率分别为36.4%、22.9%、28.6%,差异无统计学意义(P>0.05)。尚未发现XRCC1Arg194Trp和Arg399Gln基因多态性存在联合作用。结论XRCC1Arg194Trp单核苷酸多态性可能与晚期NSCLC对铂类药物的化疗敏感性相关。     

DNA修复酶XRCC1基因多态与非小细胞肺癌对GP方案化疗的敏感性

目的 研究DNA修复酶XRCC1基因Codon 194和Codon 399多态与非小细胞肺癌（NSCLC）患者对吉西他滨/顺铂（GP）方案化疗敏感性的关系.方法 收集经病理学确诊的NSCLC 57例,所有病例化疗前抽静脉血,提取白细胞DNA,用PCR-RFLP技术检测XRCC1 194和399基因型.所有患者均经PDD/GEM化疗方案治疗.结果 ①NSCLC患者中,XRCC1 194 Arg/Arg、 Arg/Trp 、Trp/Trp基因型者分别为30例（52.6%）、23例（40.4%）和4例（7.0%）;XRCC1 399 Arg/Arg、 Arg/Gln、Gln/Gln基因型者分别为31例（54.4%）、23例（40.3%）和3例（5.3%）.经化疗后,19例患者有效,总有效率33.3%.②XRCC1 194 Trp/Trp、Tp/Arg和Arg/Arg基因型者的化疗有效率分别为50.0%、52.2%和16.7%.携带Trp等位基因者的化疗有效率（51.9%）显著高于Arg/Arg基因型者（χ^2=6.41,P=0.0113）;XRCC1 399 Arg/Arg、Arg/Gln和Gln/Gln基因型者的化疗有效率分别为35.5%、34.8%和0,各组间的差异无显著性.XRCC1 194与XRCC1 399多态之间在化疗敏感性方面存在明显的交互作用,同时携带194 Arg/Arg和399 Arg/Arg基因型者的化疗有效率仅为7.7%（1/13）,而同时携带XRCC1 194 Trp等位基因和399 Arg/Arg基因型者的化疗有效率为58.8%（10/17）,2组之间差异显著（Fisher＇s双侧检验：P=0.0067）.结论 DNA修复酶基因XRCC1多态与NSCLC对GP方案化疗的敏感性有关,患者的基因型检测有可能作为预测NSCLC 对GP方案化疗敏感性的指标.     

XRCC1基因多态性与山东省籍人群胃癌易感性关系的研究

目的:研究XRCC1基因多态性与山东省人群胃癌易感性的关系.方法:采用1:1病例-对照研究方法,收集山东籍原发性胃癌病例107例,同时随机选取同性别、同民族、年龄相差±5岁、同期住院的非肿瘤、非消化道系统疾病患者作为对照,采用PCR-RFLP方法分析XRCC1基因Arg194Trp、Arg280-His和Arg399Gln 3个位点的多态性,比较不同基因型与胃癌易感性的关系.结果:在病例组和对照组194Trp的频率为53.27%和43.93%,280His的频率为12.15%和15.89%,399Gln的频率为54.21%和46.73%,差异均无统计学意义.在≥60岁年龄组携带194Trp等位基因的个体其胃癌风险增高(OR=2.303,95%CI=1.061～4.996,P=0.033),携带194Trp等位基因者可增加罹患胃底贲门癌的危险性(OR=2.766,95%CI=1.106～7.825,P=0.049)和发生远处转移的风险(OR=2.188,95%CI=1.022～4.688,P=0.042).结论:XRCC1 Arg194Trp基因多态性可增加老年人患胃癌的风险,与胃底贲门癌的发生有关,并促进胃癌的远处转移.Arg280His和Arg399Gln基因多态性与胃癌易感性无关联.     

XRCC1基因多态性与淋巴瘤发病风险的Meta分析

 目的运用Meta分析的方法综合评价DNA修复基因（X-ray repair cross-complementing group 1,XRCC1)的多 态性与淋巴瘤发病风险的关系。方法计算机检索PubMed、EMbase、中国期刊全文数据库、维普中文科技期刊数据库 、中国生物医学文献数据库,同时手工检索所有纳入文献的参考文献,收集截止到2010年2月关于XRCC1基因多态性 与淋巴瘤发病风险的病例对照研究,由两名研究者独立按照纳入标准筛选文献、提取资料并交叉核对,统计分析采 用RevMan5.0软件进行。结果共纳入11个病例对照研究,包括4 569例患者和5 746例对照。Meta分析结果显示： XRCC1 codon 399 基因型Gln/Gln、Arg/Gln和Gln/Gln+Arg/Gln与野生型Arg/Arg相比,频率差异均无统计学意义（ Gln/Gln vs. Arg/Arg:OR=1.04,95%CI［0.87,1.25］;Arg/Gln vs.Arg/Arg:OR=1.26,95%CI ［0.95,1.66］;Gln/Gln+Arg/Gln vs.Arg/Arg:OR=1.02,95%CI ［0.91,1.13］）,Gln/Gln+Arg/Gln基因型则有可 能增加霍奇金淋巴瘤的发病风险（OR=1.31,95%CI［1.02,1.69］）,XRCC1 codon280和XRCC1 codon 194的基因多 态性在患者和对照组之间的差异无统计学意义（XRCC1 codon280 His/His+Arg/His vs.Arg/Arg:OR=0.97,95%CI ［0.69,1.38］;XRCC1 codon 194 Trp/Trp+Arg/Trp vs.Arg/Arg:OR=1.01,95%CI［0.78,1.32］）。结论DNA修复 基因XRCC1的基因多态性与非霍奇金淋巴瘤发病风险没有相关性,codon399位点的Gln/Gln+Arg/Gln基因型则有可能 增加霍奇金淋巴瘤的发病风险。     

XRCC1 Arg399Gln位点多态性与乳腺癌易感性的Meta分析

[目的]评估X射线交叉互补修复基因1(X-ray repair cross complementing protein 1,XRCC1)基因Arg399Gln位点单核苷酸多态性与高加索及亚洲人群乳腺癌(breast cancer,BC)易感性的关系。[方法]检索Pub Med、Embase、中国期刊全文数据库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)和中文科技期刊全文数据库(VIP)等数据库,获取有关XRCC1 Arg399Gln位点多态性与高加索及亚洲人群乳腺癌易感性关系的病例对照研究的资料,以病例组及对照组XRCC1 Arg 399Gln等位基因分布的比值比(OR)为效应指标,应用Meta分析软件Review Manager(version 5.0.10)对各研究原始数据进行统计处理及异质性检验,计算合并OR值及其95%可信区间。[结果 ]共纳入24项病例对照研究,包括15151例乳腺癌患者和17179例对照。Meta分析结果显示,XRCC1 Arg399Gln位点Gln/Gln突变型可能会增加亚洲人群乳腺癌的发病风险[Gln/Gln vs.Arg/Arg亚洲组:OR=1.20(95%CI:1.03~1.39),P=0.02;Gln/Gln vs.Arg/Arg+Arg/Gln亚洲组:OR=1.20(95%CI:1.04~1.38),P=0.01。Gln/Gln vs.Arg/Arg OR=1.01(95%CI:0.94~1.09),Z=0.35,POR=0.73;Gln/Gln+Arg/Gln vs.Arg/Arg OR=1.02(95%CI:0.95~1.09,Z=0.58,POR=0.56;Gln/Gln vs.Arg/Arg+Arg/Gln OR=1.01(95%CI:0.95~1.08),Z=0.33,POR=0.74)。[结论]XRCC1 Arg399Gln位点Gln/Gln突变型可能与亚洲人群乳腺癌易感性相关。     

XRCC1单核苷酸多态与晚期非小细胞肺癌对铂类药物化疗敏感性的相关性

背景与目的DNA修复能力与肿瘤细胞对铂类药物的敏感性密切相关。本研究探讨DNA修复基因XRCC1单核苷酸多态性与非小细胞肺癌(non-smallcelllungcancer,NSCLC)患者对顺铂(cisplatin,DDP)或卡铂(carboplatin,CBP)为主的化疗方案敏感性的关系。方法经病理学确诊的晚期NSCLC患者105例,采用DDP或CBP为主的方案化疗,2～3个周期后进行临床疗效评价。以PCR-RFLP进行XRCC1Arg194Trp和Arg399Gln多态的基因分型,比较不同基因型对化疗敏感性的影响。比值比(OR)及其95%可信区间(CI)由logistic回归模型计算。结果携带至少一个Trp等位基因者化疗有效率为43.1%,显著高于携带Arg/Arg基因型的20.3%(OR=2.97,95%CI=1.15～7.72;P<0.05)。携带XRCC1399Arg/Arg基因型者化疗有效率为41.5%,显著高于携带至少一个Gln等位基因者的21.2%(OR=2.65,95%CI=1.03～6.87;P<0.05)。这两个多态之间存在联合作用,同时携带194Arg/Trp和399Arg/Arg基因型的患者,治疗有效率为66.7%,明显高于携带其它基因型的患者(有效率20.0%～23.1%)。结论XRCC1基因多态与NSCLC患者对铂类药物化疗的敏感性相关。     

Experience with Impedance Phlebography Compared with Venography

Venography is a particularly reliable method for the diagnosis of deep venous thrombosis but is not suitable as a screening test. Impedance phlebography represents another attempt to discover a simple, non-invasive and reliable method of detecting deep venous thrombosis. It does not, however, meet these criteria.     

Treatment with methylnaltrexone is associated with increased survival in patients with advanced cancer

BackgroundMethylnaltrexone (MNTX), a peripherally acting μ-opioid receptor (MOR) antagonist, is FDA-approved for treatment of opioid-induced constipation (OIC). Preclinical data suggest that MOR activation can play a role in cancer progression and can be a target for anticancer therapy.Patients and methodsPooled data from advanced end-stage cancer patients with OIC, despite laxatives, treated in two randomized (phase III and IV), placebo-controlled trials with MNTX were analyzed for overall survival (OS) in an unplanned post hoc analysis. MNTX or placebo was given subcutaneously during the double-blinded phase, which was followed by the open-label phase, allowing MNTX treatment irrespective of initial randomization.ResultsIn two randomized, controlled trials, 229 cancer patients were randomized to MNTX (117, 51%) or placebo (112, 49%). Distribution of patients' characteristics and major tumor types did not significantly differ between arms. Treatment with MNTX compared with placebo [76 days, 95% confidence interval (CI) 43–109 versus 56 days, 95% CI 43–69; P = 0.033] and response (laxation) to treatment compared with no response (118 days, 95% CI 59–177 versus 55 days, 95% CI 40–70; P < 0.001) had a longer median OS, despite 56 (50%) of 112 patients ultimately crossing over from placebo to MNTX. Multivariable analysis demonstrated that response to therapy [hazard ratio (HR) 0.47, 95% CI 0.29–0.76; P = 0.002) and albumin ≥3.5 (HR 0.46, 95% CI 0.30–0.69; P < 0.001) were independent prognostic factors for increased OS. Of interest, there was no difference in OS between MNTX and placebo in 134 patients with advanced illness other than cancer treated in these randomized studies (P = 0.88).ConclusionThis unplanned post hoc analysis of two randomized trials demonstrates that treatment with MNTX and, even more so, response to MNTX are associated with increased OS, which supports the preclinical hypothesis that MOR can play a role in cancer progression. Targeting MOR with MNTX warrants further investigation in cancer therapy.Clinical trials numberNCT00401362, NCT00672477.     

Compliance with guidelines and correlation with outcome in patients with advanced germ-cell tumours

PurposeTo evaluate prior compliance with guidelines in patients treated with salvage chemotherapy for advanced germ-cell tumours (GCT).Patients and methodsData concerning the initial management of patients requiring salvage chemotherapy for GCT at Institut Gustave Roussy between 2000 and 2010 were obtained and correlated with recommendations for treatment. Criteria of non-compliance were defined based on guidelines. Compliance with guidelines, predictive factors for non-compliance and the impact on outcome were analysed.ResultsAmong 82 patients treated in the salvage setting, guidelines to initial treatment were followed in only 41 cases (50%). The most common non-compliance criteria were non-adherence to the planned dose (16%), an inappropriate interval between first-line chemotherapy cycles (16%), the lack of post-chemotherapy surgery (16%) and a long interval to post-chemotherapy surgery (48%). Compliance with standard care was better in cancer centres than in other hospitals (private or public) (Odd Ratio (OR): 6.9, P = 0.001). A poor-risk status according to the International Germ Cell Cancer Collaborative Group (IGCCCG) was also predictive of compliance in univariate but not in multivariate analysis. No significant difference in outcome after salvage chemotherapy was observed. Patients relapsing after non-compliant first-line therapy tended to be more easily salvaged, which is consistent with the fact that their initial treatment was inadequate. Some of these relapses were therefore probably not due to true biologically refractory disease.ConclusionGuidelines for first-line treatment are adhered to in only half the patients requiring salvage chemotherapy. As the only predictive factor for non-compliance was the treating centre, centralisation of patients with GCT in well-trained hospitals should be recommended.     

奥沙利铂联合羟基喜树碱治疗晚期胃癌临床分析

背景与目的体外及体内的临床研究显示,奥沙利铂(L-OHP)对多种肿瘤有显著抑制作用并与绝大多数抗癌药物具有相加或协同细胞毒作用.本文旨在观察L-OHP联合羟基喜树碱(HCPT)治疗晚期胃癌的近期疗效和患者耐受性,并与传统的化疗方案进行对比.方法采用非随机的分组方法将43例晚期胃癌患者分为L-OHP+HCPT方案组(治疗组)与Vp-16+CF+5-FU(ELF)方案组(对照组),其中男性28例,女性15例,中位年龄59岁,KPS评分≥60,观察两组的近期疗效和患者耐受性.结果治疗组24例有效率58.3%(14/24),对照组19例有效率42.1%(8/19).治疗组有效率高于对照组,两组差异有显著性(P<0.05).两组不良反应主要是骨髓抑制、恶心、呕吐、口腔炎、周围神经炎、静脉炎、脱发等,均在Ⅰ、Ⅱ度范围内.结论L-OHP联合HCPT方案治疗晚期胃癌疗效较好,不良反应可以耐受.     

Living with secondary breast cancer: coping with an uncertain future with unmet needs

JOHNSTON S.R.D. (2010) European Journal of Cancer Care 19 , 561–563 Living with secondary breast cancer: coping with an uncertain future with unmet needs     

Varicella-Zoster Virus Prophylaxis with Low-Dose Acyclovir in Patients with Multiple Myeloma Treated with Bortezomib

BackgroundVaricella-zoster virus (VZV) reactivation is a common complication in patients with multiple myeloma (MM) treated with bortezomib, with an incidence rate of 10%-60%. The aim of our study was to analyze the effect of acyclovir prophylaxis in this patient population.Patients and MethodsWe studied 98 consecutive patients with relapsed MM treated with bortezomib. Bortezomib 1.3 mg/m² was given on days 1, 4, 8, and 11 of a 21-day cycle. At first, patients did not receive any VZV prophylaxis, but because of the high incidence of VZV reactivation, VZV prophylaxis with acyclovir was implemented subsequently.ResultsA total of 11 patients treated with bortezomib did not have any VZV prophylaxis, and 4 of these 11 patients (36%) developed VZV reactivation in the form of herpes zoster. No VZV reactivations were observed in the 32 patients who received acyclovir 400 mg 3 times daily or the 55 patients who received acyclovir in a dose reduced to 400 mg once daily during bortezomib treatment.ConclusionVaricellazoster virus reactivation is a common and serious adverse effect of bortezomib treatment. Acyclovir 400 mg once daily is sufficient to protect from VZV reactivation in patients with MM treated with bortezomib.     

Pseudomembranous colitis associated with chemotherapy with 5-fluorouracil

Pseudomembranous colitis is frequently associated with antibiotics and more rarely with chemotherapeutic agents such as 5-fluorouracil. The objective of this study is to show that it is possible to confuse this infection with chemotherapy associated toxicity. We present a 54 year old woman who underwent surgery for colorectal cancer and in the first cycle of chemotherapy with 5-fluorouracil developed pseudomembranous colitis. We detected the toxin B of Clostridium difficile in stools and we began early antibiotic treatment. Thus, in patients with post chemotherapy neutropenia and diarrhoea that develop negatively, we have to rule out this infection.