Department of Hematology-Oncology, Ajou University School of Medicine, Suwon 443-721, Republic of Korea.
Oral Oncol. 2010 Mar;46(3):209-13. doi: 10.1016/j.oraloncology.2009.12.007. Epub 2010 Feb 11.
We evaluated the prognostic significance of excision repair cross-complementation group 1 protein (ERCC1) and thymidylate synthase (TS) in patients with nasopharyngeal cancer (NPC) treated with concurrent chemoradiotherapy (CCRT). Pre-treatment tumor biopsy specimens from 41 patients with locally advanced NPC (stage I: 1, II: 10, III: 9, IV: 21 patients) were analyzed for ERCC1 and TS expression by immunohistochemistry. All patients were treated with one cycle of induction chemotherapy (5-fluorouracil 1000 mg/m(2)/day and cisplatin 20mg/m(2)/day, days 1-4) followed by CCRT starting on day 22. CCRT consisted of radiotherapy (70 Gy/35 fractions for 7 weeks) with cisplatin 20mg/m(2)/day for 4 days on weeks 1, 4, and 7 of radiotherapy. High expression of ERCC1 and TS was observed in 25 (60%) and 21 (51%) patients, respectively. High expression of ERCC1 was associated with WHO type 1 or 2 histology (p=0.045). With a median follow-up duration of 106 months (32-152 months) in survivors, the 5-year overall survival (OS) of all patients was 53%. In univariate analysis, 5-year OS (73% versus 39%, p=0.005) was significantly inferior in patients with high expression of ERCC1, while high expression of TS was not correlated with patient outcome. In multivariate analysis, high expression of ERCC1 was a significant independent prognostic factor for poor OS (p=0.029) along with WHO type 1 or 2 histology. High expression of ERCC1 protein may be a useful prognostic factor for poor outcome in patients with locally advanced NPC treated with CCRT.
我们评估了切除修复交叉互补基因 1 蛋白（ERCC1）和胸苷酸合成酶（TS）在接受同期放化疗（CCRT）的鼻咽癌（NPC）患者中的预后意义。对 41 例局部晚期 NPC 患者（Ⅰ期：1 例，Ⅱ期：10 例，Ⅲ期：9 例，Ⅳ期：21 例）的术前肿瘤活检标本进行 ERCC1 和 TS 表达的免疫组织化学分析。所有患者均接受 1 个周期诱导化疗（5-氟尿嘧啶 1000mg/m2/天和顺铂 20mg/m2/天，第 1-4 天），然后于第 22 天开始 CCRT。CCRT 包括放疗（7 周内 70Gy/35 次分割），第 1、4 和 7 周放疗时给予顺铂 20mg/m2/天 4 天。分别有 25（60%）和 21（51%）例患者的 ERCC1 和 TS 高表达。ERCC1 高表达与 WHO 1 型或 2 型组织学相关（p=0.045）。在生存者中中位随访 106 个月（32-152 个月），所有患者的 5 年总生存率（OS）为 53%。单因素分析显示，ERCC1 高表达患者的 5 年 OS（73%对 39%，p=0.005）明显降低，而 TS 高表达与患者结局无关。多因素分析显示，ERCC1 高表达是 OS 不良的独立预后因素（p=0.029），同时伴有 WHO 1 型或 2 型组织学。ERCC1 蛋白高表达可能是接受 CCRT 的局部晚期 NPC 患者预后不良的有用预后因素。
