非小细胞肺癌中ERCC1的表达与新辅助化疗疗效之间的关系  

Relationship between ERCC1 expression and efficacy of neoadjuvant chemotherapy in the patients with non-small-cell lung cancer

作　　者：周崧雯[1] 周彩存[1] 徐清华[1] 严令华[1] 

机构地区：[1]同济大学附属肺科医院肿瘤科

出　　处：《中国肺癌杂志》2008年第2期251-255,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的已有研究表明:肿瘤组织中核苷酸切除修复交叉互补组1(ERCC1)的阳性表达与铂类耐药密切相关,本研究探讨ERCC1在NSCLC中的表达及其与新辅助化疗疗效之间的关系。方法采用免疫组化法检测手术切除的73例NSCLC患者肿瘤组织中ERCC1的表达水平,其中33例接受含铂方案的新辅助化疗。采用χ2检验、Logrank分析和COX风险模型等分析ERCC1在NSCLC中的表达及其对新辅助化疗疗效的影响。结果ERCC1在NSCLC中的阳性表达率为34.25%。ERCC1的阳性率在新辅助化疗组(48.48%,16/33)要高于对照组(20.45%,9/40)(χ2=6.008,P=0.025)。ERCC1阳性组新辅助化疗客观缓解率31.3%,阴性组为58.8%(χ2=2.528,P=0.112);MST分别为36月和54月(P=0.118);3年生存率分别为43.8%和47.1%(χ2=0.029,P=0.866);5年生存率分别为18.8%和23.5%(χ2=0.414,P=0.520)。COX多因素回归分析结果显示:肿瘤组织中ERCC1表达水平、TNM分期和新辅助化疗与否是影响患者的预后因素。结论新辅助化疗可诱导NSCLC表达ERCC1,ERCC1高表达患者新辅助化疗客观缓解率低,ERCC1是影响该组患者预后的独立因素。Background and Objective It has been proven that ERCC1 （excision repair cross-complementation group 1）plays an important role in tumor sensitivity to platinum-based chemotherapy.This study was to examine the relationship between ERCC1 expression in NSCLCand efficacy of neoadjuvant chemotherapy. Methods Expression levels of ERCC 1 in 73 resected patients with NSCLC were detected with the method of immunohistochemistry. Expression differents of ERCC1 and its relationship with neoadjuvant chemotherapy were analysed with chi-square test, Log-rank test and Cox regression model risk. Results The positive rate of ERCC1 in NSCLC was 34.25%. Expression rate for ERCC1 in NSCLC treated with neoadjuvant chemotherapy was significantly higher than in those without neoadjuvant group （48.48% vs 20.45%, P=0.025）. Compared with the patients with ERCCl-negative tumors, the response rate in the patients with ERCCl-positive tumors was 31.3% vs 58.8%（ X^2=2.528, P=0.112）, median survival time was 36 months vs 54 months（ P=0.118）, The 3-year overall survival rate were 43.8% vs 47.1%（ X^2=0.029, P=0.866）and The 5-year overall survival rate were 18.8% vs 23.5%（X^2=0.414, P=0.520）. COX multivariate regression analysis showed that disease stages, ERCC1 expression and neoadjuvant chemotherapy were independent prognostic facts in the patients. Conclusions The expression level of ERCC1 is related to the prognosis in patients with NSCLC with neoadjuvant CT. Neoadjuvant CT can induce ERCC1 gene.

关 键 词：肺肿瘤 核苷酸切除修复交叉互补组1 新辅助化疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]