Wang Huimin, Feng Jiuxian, Zhang Xueyan, Yang Xiaohua, He Weizhong, Sha Huifang, Han Baohui
Department of Pulmonary, Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200030, China.
Zhongguo Fei Ai Za Zhi. 2009 May 20;12(5):387-95. doi: 10.3779/j.issn.1009-3419.2009.05.003.
Cisplatin is an important drug in lung cancer chemotherapy. It has been proven that ERCC1, RRM1, p53 expressions were related to resistance to platinum and prognosis of the patcents with lung cancer. The aim of this study is to analyze the association of the expression of ERCC1, RRM1, p53 with postoperative survival in patients with stage I-II non-small-cell lung cancer (NSCLC), and to explore the relationship between the expression of ERCC1, RRM1, p53 and resistance to cisplatin.
A total of 75 patients with stage I-II NSCLC receiving radical resection from Feb. 1992 to Jan. 1994 were followed up. Postoperative patients with stage I were randomized two groups (chemo and non-chemo groups). All patients with stage II received adjuvant cisplatinbased chemotherapy. Immunohistochemical staining was used to detect the expression of ERCC1, RRM1, p53 in paraffinembedded specimens.
In stage I NSCLC, the prognosis of the patients with high expression of ERCC1 (High-ERCC1) was better than those with low expression of ERCC1 (Low-ERCC1). 1, 3, 5-year survival rate in the patients with high expression of ERCC1 was 100.00%, 91.30%, 86.74% and in those with Low-ERCC1 was 96.43%, 60.71%, 57.14%, respectively (P =0.0058). The patients with High- ERCC1 had a better survival rate than those with Low-ERCC1 in stage I NSCLC without chemotherapy. MST in high and low expression of ERCC1 was 72.00(+) months and 64.67 months, respectively (P =0.0327). In contrary to stage I NSCLC, the patients with had a better survival rate than those with in stage II. MST was 60.00(+) months in stage II patients with low expression of ERCC1, but MST was only 25.50 months with (P =0.0442). The postoperative survival of NSCLC patients was not any statistical different between with high expression and low expression of RRM1 and p53.
High expression of ERCC1 is a better independent prognostic factor in stage I NSCLC patients. Cisplatin-base chemotherapy prolongs survival in stage II NSCLC patients with. Adjuvant chemotherapy regimen is determined according to ERCC1 expression levels in resected NSCLC.
顺铂是肺癌化疗中的一种重要药物。已证实，ERCC1、RRM1、p53的表达与肺癌患者对铂类的耐药性及预后相关。本研究旨在分析ERCC1、RRM1、p53的表达与Ⅰ - Ⅱ期非小细胞肺癌（NSCLC）患者术后生存的相关性，并探讨ERCC1、RRM1、p53的表达与顺铂耐药性之间的关系。
对1992年2月至1994年1月期间接受根治性切除术的75例Ⅰ - Ⅱ期NSCLC患者进行随访。Ⅰ期术后患者随机分为两组（化疗组和非化疗组）。所有Ⅱ期患者接受以顺铂为基础的辅助化疗。采用免疫组织化学染色法检测石蜡包埋标本中ERCC1、RRM1、p53的表达。
在Ⅰ期NSCLC中，ERCC1高表达（High - ERCC1）患者的预后优于ERCC1低表达（Low - ERCC1）患者。ERCC1高表达患者的1、3、5年生存率分别为100.00%、91.30%、86.74%，ERCC1低表达患者分别为96.43%、60.71%、57.14%（P = 0.0058）。在未接受化疗的Ⅰ期NSCLC中，ERCC1高表达患者的生存率高于ERCC1低表达患者。ERCC1高表达和低表达患者的中位生存时间（MST）分别为72.00（+）个月和64.67个月（P = 0.0327）。与Ⅰ期NSCLC相反，Ⅱ期患者中ERCC1低表达者的生存率高于ERCC1高表达者。Ⅱ期ERCC1低表达患者的MST为60.00（+）个月，但ERCC1高表达患者的MST仅为25.50个月（P = 0.0442）。NSCLC患者术后生存情况在RRM1和p53高表达与低表达之间无统计学差异。
ERCC1高表达是Ⅰ期NSCLC患者较好的独立预后因素。以顺铂为基础的化疗可延长Ⅱ期NSCLC患者的生存期。辅助化疗方案应根据切除的NSCLC中ERCC1表达水平来确定。
