老年性非小细胞肺癌ERCC1表达与新辅助化疗疗效的关系  

ERCC1 expression and outcomes of neo-adjuvant chemotherapy in elderly patients with non-small cell lung cancer

作　　者：李高峰[1] 邓首军[1] 王巍伟[1] 郭刚[1] 陈楠[1] 

机构地区：[1]云南省昆明市昆明医学院第三附属医院胸外科,云南昆明650118

出　　处：《南方医科大学学报》2010年第9期2131-2133,2138,共4页Journal of Southern Medical University

基　　金：云南省教育厅基金(09y0173;07Y10569)

摘　　要：目的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的相关性,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113例NSCLC患者肿瘤组织中ERCC1的表达水平,其中58例接受含铂方案的新辅助化疗。采用χ2检验、Log rank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35%。ERCC1的阳性率在新辅助化疗组为46.7%要高于对照组21.05%,(χ2=3.770,P=0.048)。ERCC1阳性表达患者39例,有效率为53.85%。ERCC1阴性表达患者74例,有效率为51.35%。新辅助化疗后ERCC1(-)患者中位生存期(MST)为53个月,ERCC1(+)患者MST为37个月,ERCC1(-)和ERCC1(+)患者的3年生存率分别为48.3%和44.4%,(χ2=0.033,P=0.856);5年生存率分别为为22.5%和18.5%,(χ2=0.096,P=0.757),它们之间无明显统计学差异。COX多因素回归分析结果显示:肿瘤组织中ERCC1表达水平和TNM分期是影响患者的预后因素(P<0.05)。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。Objective To study the association of positive expression of nucleotide excision repaircross complementary group 1（ERCC1） in the tumor tissues with platinum resistance of the tumor cells and the clinical outcomes of neo-adjuvant chemotherapy in elderly patients with non-small cell lung cancer（NSCLC）.Methods ERCC1 expression was detected immunohistochemically in the tumor tissues from 113 elderly patients with NSCLC,of which 58 patients received platinum-containing neo-adjuvant chemotherapy,and the impact of ERCC1 expression on the outcomes of neo-adjuvant chemotherapy was analyzed.Results The total positivity rate of ERCC1 expression was 35%in these patients.The positivity rates was significantly higher in the patients receiving neo-adjuvant chemotherapy than in the control group（46.7% vs 21.05%,χ2=3.770,P=0.048）.In the 39 patients positive for ERCC1,the response rate to treatment was 53.85%,as compared to the rate of 51.35%in the 74 ERCC1-negative patients.After neoadjuvant chemotherapy,the median survival time（MST） was 53 months in ERCC1-negative patients,as compared to 37 months in the positive patients.The ERCC1-negative and ERCC1-postivie patients showed similar 3-and 5-year survival rates（48.3%vs 44.4%,χ2=0.033,P=0.856;22.5%vs 18.5%,χ2=0.096,P=0.757）.Multivariate COX regression analysis showed that ERCC1 expression level in the tumor tissue and TNM stages were independent factors that affected the prognosis of the patients（P〈0.05）.Conclusion Neoadjuvant chemotherapy can induce ERCC1 expression in the tumor,and the objective response rate of neoadjuant chemotherapy can be low in NSCLC patients with high ERCC1 expression.ERCC1 expression is an independent factor affecting the prognosis of elderly patients with NSCLC receiving neoadjuant chemotherapy.

关 键 词：肺肿瘤核苷酸切除修复交叉互补组1 肺肿瘤 新辅助化疗 

分 类 号：R734.2[医药卫生—肿瘤]