Liang Weijun, Hu Chengping, Gu Qihua, Song Min, Luo Wanjun
Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhongguo Fei Ai Za Zhi. 2009 May 20;12(5):403-7. doi: 10.3779/j.issn.1009-3419.2009.05.005.
It has been proved that the chemotherapy respouse was related to the expression levels of tumor genes in lung cancer. The aim of this study was to explor the relationship of ERCC1, RRM1 expression and the benefits from postoperative cisplatin combined with gemcitabine (GP) chemotherapy in patients with non-small cell lung cancer (NSCLC).
All 57 postoperative patients with stage II-IV NSCLC were entered into the study, and 39 cases of patients were at least received 2 cycles of cisplatin combind with gemcitabine chemotherapy, 18 cases with no chemotherapy. Immunohistochemistry was performed in paraffin-embedded tumor specimens to investigate ERCC1, RRM1 expression. Cox proportional regression analysis was used to screen independent prognostic risk factors for survival. Comparisons of the median survival time among groups were based on Kaplan-Meier analysis.
Cox regression analyses showed that the extent of tumor resection, chemotherapy after surgical resection and expressions of ERCC1 were independent prognostic factors. In the group of high expression of ERCC1, the median survival time of postoperative chemotherapy patients and control were 42 and 12 months respectively (P =0.018). In the group with low expression of ERCC1, the median survival time of postoperative chemotherapy patients and control were 23 and 21 months respectively (P =0.088). However, In the group of high expression of RRM1, the median survival time of postoperative chemotherapy patients and control were 28 and 21 months respectively (P =0.092). In the group with low expression of RRM1, the median survival time of postoperative chemotherapy patients and control were 42 and 22 months respectively (P =0.010).
The NSCLC patients with high expression of ERCC1 and low expression of RRM1 get more probablely benefits from postoperative cisplatin combine gemcitabine chemotherapy.
已证实肺癌的化疗反应与肿瘤基因的表达水平相关。本研究旨在探讨非小细胞肺癌（NSCLC）患者中ERCC1、RRM1表达与术后顺铂联合吉西他滨（GP）化疗疗效之间的关系。
57例Ⅱ-Ⅳ期NSCLC术后患者纳入本研究，其中39例患者至少接受了2周期顺铂联合吉西他滨化疗，18例未接受化疗。采用免疫组织化学法检测石蜡包埋肿瘤标本中ERCC1、RRM1的表达。采用Cox比例回归分析筛选生存的独立预后危险因素。基于Kaplan-Meier分析比较各组的中位生存时间。
Cox回归分析显示，肿瘤切除范围、手术切除后化疗及ERCC1表达是独立的预后因素。在ERCC1高表达组，术后化疗患者和对照组的中位生存时间分别为42个月和12个月（P =0.018）。在ERCC1低表达组，术后化疗患者和对照组的中位生存时间分别为23个月和21个月（P =0.088）。然而，在RRM1高表达组，术后化疗患者和对照组的中位生存时间分别为28个月和21个月（P =0.092）。在RRM1低表达组，术后化疗患者和对照组的中位生存时间分别为42个月和22个月（P =0.010）。
ERCC1高表达且RRM1低表达的NSCLC患者更有可能从术后顺铂联合吉西他滨化疗中获益。
