切除修复交叉互补基因1在胃癌术后患者中的差异表达及预后  

Differential expression and prognostic value of excision repair cross-complementing gene-1 in resected gastric adenocarcinoma

作　　者：严伟[1] 赵勇[1] 何军[1] 潘旭松[1] 付彪[1] 刘兵[1] 王方为[1] 付前聪[1] 王法社[1] 

机构地区：[1]安徽省六安市人民医院肿瘤外一科237000

出　　处：《中国综合临床》2017年第5期449-454,共6页Clinical Medicine of China

摘　　要：目的 切除修复交叉互补基因1（ERCC1）是关键的调节酶,在某些肿瘤的表达与患者的预后相关.探讨ERCC1胃癌中的表达情况及应用价值.方法 2010年1月至2013年1月安徽省六安市人民医院共收治109例胃癌术后患者,通过免疫组化方法评估ERCC1在胃癌组织中的表达差异,并评估ERCC1的表达与患者生存期的关系.结果 中位随访时间为21.2个月,中位生存期28.8个月.胃癌患者ERCC1高表达25例（23%）,且与总生存期无相关性（18.9个月与27.7个月,P=0.72）.进一步分析73例接受化疗患者,ERCC1高表达总生存期降低（16.7个月 与 53.8个月,P=0.03）.控制已知的不良病理特征后,通过多变量回归分析,ERCC1高表达提示是预后不良的因素（HR=2.22,95%CI 1.05~4.98;P〈0.05）.35例只行手术治疗患者ERCC1高表达总生存期延长（40.4 个月与12.7个月,P=0.10）;在多因素回归分析中得到同样的结果（HR=0.20,95%CI 0.05~0.84,P=0.03）.结论 ERCC1在可切除胃癌患者中表达不同,且表达水平与总生存期无关.ERCC1高表达的胃癌患者中,术后辅助化疗较单纯手术患者的生存期缩短.ERCC1在胃癌中有预测价值,未来需进一步研究.Objective Excision repair cross-complementing gene-1（ERCC1） are key regulatory enzymes whose expression patterns are associated with overall survival（OS） in several malignancies.Their expression patterns and prognostic value in resected gastric adenocarcinoma（GAC） are not known and need to investigate.Methods A total of 109 patients who underwent resection for GAC in Liu′an People′s Hospital from January 2010 to June 2013 had tissue available for analysis.The primary objective was to assess for the differential expression of ERCC1 using by immunohistochemistry.The secondary objective was to assess for the association between OS and the expression of ERCC1.Results The median follow-up was 21.2 months,and the median OS was 28.8 months.Resected GAC exhibited differential expression of ERCC1（high expression,n=25（23%））.ERCC1 expression was not associated with OS（18.9 months vs.27.7 months,P=0.72）.In a subset analysis of patients who received chemotherapy（n=73）,high ERCC1 expression was associated with decreased OS（16.7 months vs.53.8 months,P=0.03）.After controlling for known adverse pathologic features,high ERCC1 expression persisted as a negative prognostic factor in multivariate Cox regression analysis（HR=2.22,95% CI1.05-4.98,P〈0.05）.Conversely,in patients who underwent resection only（n=35）,high ERCC1 expression demonstrated a trend toward improved OS（40.4 months vs.12.7 months,P=0.10）.A positive prognostic influence also was present on multivariate analysis（HR=0.20,95% CI0.05-0.84,P=0.03）.Conclusion Resected GAC exhibited differential expression of ERCC1.Among all patients,ERCC1 expression levels were not associated with OS.High ERCC1 tumor expression is associated with decreased OS in the patients who received chemotherapy but is associated with increased OS in those who underwent surgery alone.ERCC1 expression have prognostic value in resected gastric cancer,and further investigation is needed.

关 键 词：胃癌 切除修复交叉互补基因1 分子标记物 

分 类 号：R735.2[医药卫生—肿瘤]