ERCC1、BRCA1和TS表达水平在进展期结直肠癌中的临床意义  

Clinical significance of the expression levels of ERCC1, BRCA1 and TS in advanced colorectal cancer

作　　者：夏志秀[1] 王昌亮[2] 丛进春[1] 张国华[2] 冯勇[1] Xia Zhixiu Wang Changliang Cong Jinchun Zhang Guohua Feng Yong

机构地区：[1]中国医科大学附属盛京医院普通外科,沈阳110004 [2]中国医科大学法医学院

出　　处：《中国医师进修杂志》2017年第8期697-703,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨核苷酸切除修复交叉互补基因1（ERCC1）、人类乳腺癌易感基因1（BRCA1）和胸苷酸合成酶（TS）mRNA在进展期结直肠癌组织中的表达水平与其临床病理特征、预后的关系,以及ERCC1 mRNA和BRCA1 mRNA表达水平之间的相关性.方法 采用实时荧光定量逆转录聚合酶链反应（RT-PCR）检测49例进展期结直肠癌术后石蜡病理组织的ERCC1、BRCA1和TS mRNA表达水平,表达水平与临床病理指标用四格表χ2检验进行结果分析,术后通过门诊或电话随访患者,预后比较采用小样本Kaplan-Meier生存分析和Log-rank时序检验分析方法,P〈0.05为差异有统计学意义.结果 ERCC1 mRNA表达水平与结直肠癌患者的性别、年龄、肿瘤发生部位、淋巴结转移、远处转移、CEA、分化程度等临床病理特征无明显相关性（P〉0.05）;BRCA1 mRNA表达水平与远处转移（P=0.030）、肿瘤分化程度（P=0.002）相关,与其他临床病理特征无明显相关性（P〉0.05）;TS mRNA表达水平与远处转移（P=0.003）相关,与其他临床病理特征无明显相关性（P〉0.05）.ERCC1与BRCA1 mRNA表达水平具有相关性（P=0.002）.1年总生存率为95.92%（47/49）;2年总生存率为83.67%（41/49）;3年总生存率为73.47%（36/49）.ERCC1 mRNA低表达组（47.8个月、41.0个月）较高表达组（27.3个月、20.0个月）总生存时间、无病生存时间长（P=0.001、P=0.001）;BRCA1 mRNA低表达组（43.7个月、42.7个月）较高表达组（29.3个月、25.1个月）总生存时间、无病生存时间长（P=0.009、0.006）;TS mRNA低表达组（39.8个月）较高表达组（25.2个月）无病生存时间长（P=0.030）.结论 ERCC1 mRNA表达水平与结直肠癌患者的临床病理特征无关,仅与其自身的生物学特征有关,BRCA1和TS与结直肠癌的侵袭转移有关.低水平ERCC1和BRCA1表达对以铂类为基础的结直肠癌一线化疗具有更好的预后效果且两者相关,低水平TS也具有更长Objective To explore the relationship between the expression levels of excision repair cross complementation group 1（ERCC1）, breast cancer susceptibility gene 1（BRCA1）, thymidylate synthase （TS） mRNA and clinicopathological features, prognosis in advanced colorectal cancer, and the correlation between the expression levels of ERCC1 and BRCA1. Methods The expression levels of ERCC1, BRCA1 and TS mRNA of postoperative paraffin embedded tissue were tested by real-time quantitative reverse transcription polymerase chain reaction （RT-PCR） in 49 advanced colorectal cancer cases. The results were analyzed by χ2 test of the correlation between the expression levels and clinicopathological characteristics. Patients were followed up by clinic or telephone. The prognosis was analyzed by small sample Kaplan-Meier survival analysis and Log-rank time series analysis, and P〈0.05 was statistically significant. Results The expression level of ERCC1 mRNA in patients with colorectal carcinoma had no obvious correlation with the clinical and pathological characteristics such as gender, age, tumor location, lymph node metastasis, distant metastasis, CEA and differentiation degree （P〉0.05）. The expression level of BRCA1 mRNA had no significant correlation with the above clinical and pathological features （P〉0.05） except distant metastasis （P=0.030） and differentiation degree （P=0.002）. The expression level of TS mRNA had no significant correlation with the above clinical and pathological features （P〉0.05） except distant metastasis （P=0.003）. The expression level of ERCC1 and BRCA1 mRNA obviously correlated （P=0.002）. The 1 year overall survival rate was 95.92%（47/49）;the 2 year overall survival rate was 83.67%（41/49）;and the 3 year overall survival rate was 73.47%（36/49）. Overall survival and progression-free survival time in ERCC1 mRNA low expression group （47.8, 41.0 months） was higher than that in ERCC1 mRNA low expression group （27.3, 20.0 months） respectivel

关 键 词：结直肠肿瘤 核苷酸切除修复交叉互补基因1 人类乳腺癌易感基因1 胸苷酸合成酶 

分 类 号：R735.34[医药卫生—肿瘤]