联合检测ERCC1 mRNA和Topo1 mRNA指导晚期结直肠癌患者个体化化疗的临床价值  

The Clinical value of individualized chemotherapy on patients with advancedcolorectal cancer patients under the guidance of ERCC1 mRNA and Topo1 mRNA testing

作　　者：张修振[1] 邹忠平[1] 闫燕[1] 陈成武[1] 亓玉琴[2] 

机构地区：[1]泰山医学院附属莱钢医院消化内科,山东莱芜271126 [2]青岛市市立医院消化内科,山东青岛266000

出　　处：《中国中西医结合消化杂志》2015年第9期629-633,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]探讨切除修复交叉互补基因1(excision repair cross complement group1,ERCC1)、拓扑异构酶-1(Topo1)指导化疗药物个体化选择在晚期结直肠癌患者的疗效和安全性。[方法]采用实时荧光定量RT-PCR,检测178例晚期结直肠癌患者中ERCC1、TOPO1表达情况,分为实验组、对照组,分析化疗疗效,并作生存分析。[结果](1)肿瘤组织和外周血淋巴细胞中ERCC1、TOPO1表达水平呈正相关(r=0.615、0.508)。(2)第1组(实验组):根据ERCC1、TOPO1表达水平选择化疗方案,第2组(对照组)。实验组临床有效率为51.6%(32/62),与对照组疗效比较,差异有统计学意义(χ2=4.052,P<0.05);生存分析显示,实验组与对照组的TTP分别为10.9个月和7.1个月,P<0.05,MST分别为15.8个月和12.2个月,P<0.05,差异有统计学意义。[结论]联合检测ERCC1mRNA、TOPO1mRNA的表达水平,可为结直肠癌患者个体化化疗方案的制定提供参考依据。[Objective] To explore the efficacy and safety of individualized selection of chemotherapy drug guided by combing detection of ERCC1 mRNA and TOPO1 mRNA in patients with advanced colorec- tal cancer. [Methods]The expression of ERCC1 mRNA and TOPO1 mRNA of the peripheral bloods were examined by Real-time fluorescent quantitative PCR technique in 178 cases of colorectal cancer patients and 58 healthy controls volunteers. The data of therapeutical effect were collected and analyzed, and the survival analysis was conducted. [Resuits]（1）Both the ERCC1 and TOPO1 expression in tumor tissues were posi- tively correlated with that in peripheral blood lymphocytes, （r = 0.615,0. 508, respectively）. （2） The pa- tients were divided into two groups. Patients in 1 st group（n= 62） received chemotherapy based on the ex- pression of ERCC1 mRNA and TOPO1 mRNA. Patients in 2 nd（n= 57）randomly received chemotherapy respectively. The response rates of chemotherapy（CR＋PR）in 2 groups were 51.6%（32/62）,33.3（19/57） respectively. There was significant difference in the response rate between group 1 and group 2（X^2 =4. 052, P=0. 044）. （3）There were significant differences in the expression of TTP and MST between group 1 and group 2. [Conclusion]Individual chemotherapy can be selected base on the expression of ERCC1 mRNA and TOPO1 mRNA in patients with advanced colorectal cancer.

关 键 词：结直肠癌 切除修复交叉互补基因1 TOPO1 耐药性 实时荧光定量逆转录聚合酶链反应 

分 类 号：R735.3[医药卫生—肿瘤]