Department of Urology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Urol Oncol. 2013 Nov;31(8):1709-15. doi: 10.1016/j.urolonc.2012.06.014. Epub 2012 Aug 3.
Excision repair cross-complementation group 1 enzyme (ERCC1) plays a key role in the removal of platinum induced DNA adducts and cisplatin resistance. Prognostic role of ERCC1 expression in the neoadjuvant setting in bladder cancer has not been reported before. We evaluated the prognostic role of ERCC1 expression in bladder cancer receiving platinum-based neoadjuvant chemotherapy.
Thirty-eight patients with muscle invasive bladder cancer who received neoadjuvant platinum-based chemotherapy were included. Clinical and histopathologic parameters along with immunohistochemical ERCC1 staining were examined and correlated with response rates and survival.
Pathologic complete response rates were similar between patients with low and high ERCC1 expression. Median disease-free survival (DFS) was 9.3 vs. 20.5 months (P = 0.186) and median overall survival (OS) was 9.3 vs. 26.7 months (P = 0.058) in patients with high ERCC1 expression compared with those with low expression, respectively. In multivariate Cox regression analysis: pathological complete response (pCR) after chemotherapy (hazard ratio (HR) 0.1, 95% CI 0.012-0.842, P = 0.034) and high ERCC1 expression (HR 3.7, 95% CI 1.2-11.2, P = 0.019) were significantly associated with DFS. Patient age (>60 vs. ≤ 60 years) (HR 3.4, 95% CI 1.2-9.4, P = 0.018), the presence of pCR (HR 0.11, 95% CI 0.014-0.981, P = 0.048) and high ERCC expression (HR 6.1, 95 CI 1.9-19.9, P = 0.002) were significantly associated with OS.
Our results showed that high ERCC1 expression was independently associated with shorter disease-free and overall survival in patients with bladder cancer who received neoadjuvant platinum-based chemotherapy. ERCC1 may represent a potential predictive marker for platinum-based treatment in bladder cancer.
切除修复交叉互补基因 1 酶（ERCC1）在去除铂诱导的 DNA 加合物和顺铂耐药中起关键作用。ERCC1 表达在新辅助设置中的预后作用在膀胱癌中尚未报道。我们评估了 ERCC1 表达在接受基于铂的新辅助化疗的膀胱癌中的预后作用。
纳入 38 例接受新辅助铂类化疗的肌层浸润性膀胱癌患者。检查临床和组织病理学参数以及 ERCC1 免疫组织化学染色，并与反应率和生存率相关。
低表达和高表达 ERCC1 的患者病理完全缓解率相似。高 ERCC1 表达组的无病生存期（DFS）中位数为 9.3 个月，而低表达组为 20.5 个月（P=0.186），高 ERCC1 表达组的总生存期（OS）中位数为 9.3 个月，而低表达组为 26.7 个月（P=0.058）。多变量 Cox 回归分析：化疗后病理完全缓解（pCR）（危险比（HR）0.1，95%CI 0.012-0.842，P=0.034）和高 ERCC1 表达（HR 3.7，95%CI 1.2-11.2，P=0.019）与 DFS 显著相关。患者年龄（>60 岁与≤60 岁）（HR 3.4，95%CI 1.2-9.4，P=0.018）、pCR 存在（HR 0.11，95%CI 0.014-0.981，P=0.048）和高 ERCC 表达（HR 6.1，95CI 1.9-19.9，P=0.002）与 OS 显著相关。
我们的结果表明，高 ERCC1 表达与接受新辅助铂类化疗的膀胱癌患者无病生存和总生存时间较短独立相关。ERCC1 可能是膀胱癌铂类治疗的潜在预测标志物。
