晚期非小细胞肺癌组织中ERCC1表达与铂类药物化疗敏感性关系及其临床意义

目的：研究探讨晚期非小细胞肺癌组织中DNA切除修复交叉互补基因1（excision repair cross-comple-menting 1,ERCC1）的表达与顺铂方案化疗敏感性的关系,并观察该指标与患者生存的关系。方法：收集2001年1月~2006年12月在本科经病理组织学诊断的用顺铂方案化疗的初治晚期（ⅢB、Ⅳ期）非小细胞肺癌患者的病理标本81例,采用免疫组化方法检测ERCC1的表达情况,将患者的疗效和生存资料与该指标的表达进行比较,样本率的比较用χ2检验,用Kaplan-meier法进行生存分析。结果：81例患者中,ERCC1染色阳性29例,阳性率为35.8%,与患者的性别、年龄、状态评分、分期及是否吸烟无关,腺癌表达高于鳞癌。ERCC1表达阳性组化疗有效率为20.69%,ERCC1表达阴性组化疗有效率为55.77%,组间差异有统计学意义（P〈0.05）。ERCC1表达阳性组中位生存时间为303天,ERCC1表达阴性组为564天,用Kaplan-meier进行单因素生存分析,其差异有统计学意义（P〈0.05）。结论：ERCC1表达不同是晚期NSCLC患者化疗方案中铂类药物敏感性差别的重要因素,检测其表达可以预测晚期肺癌的铂类药物化疗的敏感性,其阳性表达提示预后不良。本研究可为临床上NSCLC患者个体化疗方案的制定及判断预后提供参考。

Expression of ERCC1 and the correlation with platinum-based chemotherapy sensitivity and clinical significance in the advanced non-small cell lung cancer

Objective： To investigate the expression of ERCC1 and the correlation with platinum-based chemotherapy sensitivity in advanced non-small cell lung cancer（NSCLC） as well as its clinical prognostic significance.Methods：The expression of ERCC1 was examined by immuno histoche-mical technique in 81 patients with advanced non-small cell lung cancer.All patientswere treated with platinum-based chemotherapy.Results：Inthese 81 cases,positive expression rates of ERCC1 was 38.5%（29/81）,and there were no correlation with patient age,gender,scor,clinical stage and smoking,but its expression in pulmonary adenocarcinoma was higher than that in squamous carcinoma.The response rate of platinum-based chemotherapy in positive expression group was 20.69%,which in negative group was 55.77%,and there was significant difference between the two groups（P0.05）.The medial survival time was 303 days in ERCC1 expression positive group,which was 564 days in ERCC1 expression negative group,survival analysis was carried by Kaplan-Meier analysis and there has significant difference（P0.05）.Conclusion：The expression of ERCC1 correlate with paltinum-based chemothempy sensitivity and could predict the sensitivity in advanced non-small cell lung cancer.Positive expression of ERCC1 predicates poor prognosis for patients with advanced NSCLC.The result of this study may provide new sight for tailor chemotherapy（TC） and decision prognosis to individual NSCLC patients.