ERCC1对顺铂同期放化疗治疗局部晚期鼻咽癌疗效的预测

目的 探讨核苷酸切除修复交叉互补基因1（ERCC1）表达水平对局部晚期鼻咽癌应用顺铂同期放化疗的疗效预测作用。方法回顾性分析本院2001年1月至2009年1月行顺铂同期放化疗的205例局部晚期鼻咽癌患者，根据治疗结果分为治疗敏感组和治疗抵抗组。采用免疫组织化学法检测鼻咽癌组织中ERCC1的表达并分析ERCC1表达与治疗有效率、5年无病生存率和5年生存率的关系。结果在205例鼻咽癌组织中，110例（53.7％）ERCC1高表达，95例（46.3％）ERCC1低表达。ERCC1高表达组的有效率（RR）为97.3％（107／110），ERCC1低表达组为100.0％（95／95），差异无统计学意义（P＞0.05）。治疗敏感组的ERCC1低表达率与高表达率分别为61.4％和38.6％，而治疗抵抗组分别为35.9％和64.1％，两组表达的差异有统计学意义（P=0.000）。ERCC1低表达和高表达组的中位生存期分别为61.3个月和49.7个月（P=0.013），5年无病生存率分别为61.5％和36.2％（P=0.054），5年生存率分别为63.4％和38.5％（P=0.037）。Cox多因素分析显示，ERCC1表达、PS评分及分期为影响预后的独立因素。结论 ERCC1可以作为局部晚期鼻咽癌的疗效预测指标，ERCC1高表达的患者预后差。

Predictive value of ERCC1 expression in local advanced nasopharyngeal cancer receiving cisplatin-based concurrent chemoradiotherapy

Objective To investigate the effect of excision repair cross-complementation group 1 （ERCC1） expression on response to cisplatin-based chemoradiotherapy in locally advanced nasopharyngeal cancer（NPC） patients.Methods In a retrospective study,205 patients with locally advanced NPC from January 2001 to January 2009 were divided into treatment-sensitivity group and treatment-resistant group.Immunohistochemistry was used to assess ERCC1 expression in NPC tissue.The relationships between ER-CC1 expression and response rate （RR）,5-year disease-free survival rate and overall survival rate were analyzed.Results Of 205 NPC patients,ERCC1were highly expressed in 110 cases and lowly expressed in 95 cases.The RR in NPC patients with high ERCC1 expression（97.3%） and those with low ERCC1 expression（100.0%） had no statistical difference.The low expression and high expression rate of ERCC1 in the treatment-sensitive group were 61.4% and 38.6%,significantly different from 35.9% and 64.1% in the treatment-resistant group （P =0.000）.The median overall survival in patients with low ERCC1expression and high ERCC1expression were 61.3 and 49.7 months（P =0.013）.The 5-year disease-free survival rate were 61.5% and 36.2% （P =0.054） and the 5-year overall survival rate were 63.4% and 38.5 %,respectively （P =0.037）.Multivariate analysis showes the ERCC1 expression,stage and PS status were independent predictors for overall survival.Conclusion ERCC1 expression might be a useful predictive marker of clinical effect in patients with locally advanced NPC receiving cisplatin-based concurrent chemoradiotheapy.