切除修复交叉互补基因1表达对进展期胃癌新辅助化疗及预后的影响  

The effect of expressions of ERCCI on neoadjuvant chemotherapy and prognosis in advanced gastric cancer

作　　者：宋延强[1] 马贵亮[1] 刘超[1] 马雷[1] 毛伟征[1] 李杨[1] 

机构地区：[1]青岛大学医学院附属青岛市市立医院普通外科,山东省266071

出　　处：《中华普通外科杂志》2012年第5期360-363,共4页Chinese Journal of General Surgery

基　　金：青岛市科技局科技资助项目（KZD-232007）

摘　　要：目的探讨切除修复交叉互补基因1（excisionrepaircrosscomplement1，ERCC1）的表达对进展期胃癌辅助化疗及预后的影响。方法进展期胃癌患者共88例，分为新辅助组45例，手术组43例。新辅助组行2个疗程XELOX方案新辅助化疗，再行标准胃癌根治术，术后再行4个疗程的XELOX方案化疗；手术组行标准胃癌根治术，术后行6个疗程的XELOX方案化疗。对2组均随访3年，观察疗效及3年无复发生存率。结果新辅助组和手术组患者ERCCl阳性表达率分别为49％和44％。新辅助组45例患者化疗有效率为49％，ERCCI阴性表达患者对化疗敏感（P〈0．05）。ERCCl阴性表达患者3年无复发生存率为64％，显著高于阳性表达患者的30％，两者相比差异有统计学意义，P〈0．05；手术组ERCC1阴性表达患者3年无复发生存率为79％，显著高于阳性表达患者的38％，两者相比差异有统计学意义，P〈0．05。COX回归模型分析结果显示ERCC1表达与3年无病生存率密切相关，P〈0．05。结论ERCC1的表达与进展期胃癌患者的化疗敏感性及预后有关，可用于其预后及化疗敏感性的预测。Objective To investigate the effect of expression of excision repair cross complementing 1 （ERCC1） on adjuvant chemotherapy and prognosis in advanced gastric cancer. Methods In this study 88 advanced gastric cancer cases were divided into initial neoadjuvant chemotherapy group （45 patients） and upfront surgical group （43 cases）. In neoadjuvant chemotherapy group two courses neoadjuvant chemotherapy with XELOX were given before an interval standard radical gastrectomy. Postoperatively another four cycles of chemotherapy with XELOX were given; In upfront surgical group standard radical gastrectomy was done followed by 6 cycles of postoperative chemotherapy with XELOX; Patients in the two groups were followed up for 3 years. Results ERCC1 positive expression were 49% and 44% in neoadjuvant group and surgical patients; Response rate in neoadjuvant chemotherapy group was 49%. Patients with ERCClnegative expression were more sensitive to chemotherapy （P 〈 0. 05）; 3-year recurrence-free survival rate in patients with ERCC1 negative expression was 64%, which was significantly higher than 30% in patients with positive expression, the difference was statistically significant （P 〈 0. 05 ） ; 3-year recurrence-free survival rate in initial surgical group patients with ERCCl-negative expression was 79%, significantly higher than in patients with positive expression （ 38% ）, the difference was statistically significant （P 〈0. 05） ; Cox regression analysis revealed that ERCCI expression is closely related to 3-year disease-free survival （P 〈 0.05 ）. Conclusions ERCC1 expression in patients with advanced gastric cancer is related to chemosensitivity and prognosis, it can forecast the prognosis and chemotherapy sensitivity.

关 键 词：胃肿瘤 基因表达 抗肿瘤联合化疗方案 预后 

分 类 号：R735.2[医药卫生—肿瘤]