Department of Obstetrics and Gynecology, Gynecologic Cancer Multidisciplinary team, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.
Gynecol Oncol. 2011 Feb;120(2):275-9. doi: 10.1016/j.ygyno.2010.10.034. Epub 2010 Nov 19.
Platinum-based neoadjuvant chemotherapy for locally advanced cervical cancer has some benefits for patients responding to chemotherapy. However, no validated clinical or biologic predictor of response to this chemotherapy has been identified to date.
We employ immunohistochemical analysis to determine the expression patterns of the excision repair cross-complementation group1 (ERCC1) protein in pre-treatment cervical biopsy tissue. In total, 43 stage IIB patients had been enrolled in a previous etoposide and cisplatin neoadjuvant phase II clinical trial, allowing comparison of the effects of cisplatin-based neoadjuvant chemotherapy on response in relation to ERCC1 expression.
Among the 43 patients studied, 34 (79.1%) were positive and 9 (20.9%) were negative for ERCC1. Response to chemotherapy (according to RECIST criteria) was observed in all patients with negative ERCC1 expression. In logistic regression analysis, ERCC1 negativity continued to be an independent predictor for responsiveness to neoadjuvant chemotherapy (p=0.021). Among the pretreatment factors, low ERCC1 expression was a significant prognostic factor of disease-free survival in multivariate analysis (p=0.046).
The ERCC1 expression patterns in pretreatment specimens may thus facilitate the prediction of responses to cisplatin-based NAC. We propose that patients expressing low levels of ERCC1 derive the most benefit from cisplatin-based NAC.
铂类新辅助化疗对局部晚期宫颈癌患者有一定益处，可使化疗敏感的患者获益。然而，目前尚未发现有效的预测化疗疗效的临床或生物学标志物。
我们采用免疫组织化学分析法，检测预处理宫颈活检组织中切除修复交叉互补基因 1（ERCC1）蛋白的表达模式。共有 43 例 IIB 期患者参加了前期依托泊苷联合顺铂新辅助 II 期临床试验，可比较顺铂为基础的新辅助化疗对 ERCC1 表达相关的反应效果。
在 43 例研究患者中，34 例（79.1%）ERCC1 阳性，9 例（20.9%）ERCC1 阴性。所有 ERCC1 表达阴性的患者均对化疗有反应（根据 RECIST 标准）。在逻辑回归分析中，ERCC1 阴性仍是新辅助化疗反应的独立预测因子（p=0.021）。在预处理因素中，ERCC1 低表达是多因素分析中疾病无进展生存的显著预后因素（p=0.046）。
因此，预处理标本中 ERCC1 的表达模式有助于预测顺铂为基础的 NAC 的反应。我们提出，表达低水平 ERCC1 的患者从顺铂为基础的 NAC 中获益最大。
