胃癌的Lauren分型与ERCC1、BRCA1、XRCC1表达及临床病理特征的关系  

Correlation between Lauren classification and the expression of ERCCl,BRCAl,XRCCl and climcopathological characteristics in gastric cancer

作　　者：周易[1] 朴正爱[2] 王海[2] 阎欣[1] 李萍[1] 范丽昕[1] 

机构地区：[1]大连市第三人民医院肿瘤内科,辽宁大连116031 [2]大连市第三人民医院病理科,辽宁大连116031

出　　处：《癌症进展》2016年第11期1142-1145,共4页Oncology Progress

摘　　要：目的探讨胃癌不同Lauren分型中ERCC1、BRCA1、XRCC1的表达及其与临床病理特征的关系。方法收集62例胃癌根治术且术后接受含铂方案辅助化疗、资料完整患者的临床资料和手术标本。采用免疫组织化学方法分别检测手术标本的ERCC1、BRCA1、XRCC1表达情况,分析Lauren分型与肿瘤临床病理学特征的关系及ERCC1、BRCA1、XRCC1在不同Lauren分型中表达的差异。结果肠型胃癌男性82%高于女性的18%;弥漫型胃癌女性59%高于男性的41%,组间比较差异均有统计学意义(P=0.001);年龄上两组差异无统计学意义(P=0.139);肿瘤部位上,肠型以近端胃为多,弥漫型则以远端胃居多(P=0.03);肿瘤分化程度上,肠型胃癌分化较好,而弥漫型胃癌分化较差(P=0.000);ERCC1在肠型胃癌表达率为27%,低于弥漫型胃癌的52%(P=0.049);XRCC1在肠型胃癌表达率为30%,低于弥漫型胃癌的59%(P=0.025);BRCA1在肠型胃癌表达率为18%低于弥漫型胃癌的24%,差异无统计学意义(P=0.565);肠型胃癌患者中位无病生存期(DFS)为20个月,弥漫型患者中位DFS为13个月(P=0.04)。结论 Lauren分型弥漫型胃癌分化差,预后差,ERCC1及XRCC1表达率较肠型胃癌高,可能与铂类耐药相关。Objective To investigate the expression of ERCC1, BRCA1 and XRCC1 in gastric cancer based on Lau-ren classification and the correlation with clinicopathological characteristics. Method Clinical data and tissue samples of 62 gastric cancer patients who received radical gastrectomy and postoperative platinum-based adjuvant chemotherapy were analyzed retrospectively. Immunohistochemical assay was used to test the expression of ERCC1, BRCA1 and XRCC1 in surgical samples. The associations between Lauren classification and clinicopathological characteristics were analyzed, and the differences of ERCC1, BRCA1 and XRCC1 expressions among different Lauren classifications were analyzed. Result Intestinal-type gastric cancer occurred predominantly in male patients （82%vs 18%in females）, and the diffuse type exhibited a preference in female patients compared with the intestinal type （59%vs 41%, P=0.139）. The tumor＆#39;s site of the intestinal type was mostly in proximal stomach, and diffuse type was mainly found in distal stomach （P=0.03）.Intestinal-type gastric cancer were relatively well differentiated compared with diffuse type （P=0.000）. Positive rate of ERCC1 expression was 27%in intestinal type and 52%in diffuse type （P=0.049）;Positive rate of XRCC1 expres-sion was 30%in intestinal type and 59%in diffuse type （P=0.025）;But there was no significant difference in BRCA1 ex-pression, with positive rates being 18%in intestinal type and 24%in diffuse type （P=0.565）. The median DFS in intesti-nal type were 20 months and 13 months in diffuse type （P=0.04）, respectively. Conclusion Patients with diffuse type gastric cancer has a worse pathologic differentiation and higher expression rate of ERCC1 and XRCC1 compared with in-testinal-type gastric cancer, which may be associated with platinum resistance.

关 键 词：胃癌 Lauren分型 ERCC1 XRCC1 BRCA1 铂类耐药 

分 类 号：R735.2[医药卫生—肿瘤]