卵巢癌中 ERCC1 和激素受体表达的意义。

Department of Medical Oncology, Ahmed Maher Teaching Hospital, Cairo, Egypt.

Department of medical oncology, NCI ,Cairo University, Cairo, Egypt.

J Med Invest. 2020;67(3.4):391-398. doi: 10.2152/jmi.67.391.

Background & Objectives : Ovarian carcinoma usually has a relatively poor prognosis. A rational approach to identify patients, who are likely to benefit from therapy, is urgently needed. Excision repair cross-complementation group 1 enzyme (ERCC1) has been proposed as a molecular predictor of clinical resistance to platinum-based chemotherapy. Steroid hormone receptors are important determinants of prognosis and predictive behavior in tumor tissues of several origins. The present study aimed to investigate the expression profile of ERCC1, ER & AR in patients with Ovarian carcinoma and their association with patient outcome. Methods : This is a prospective study which included 77 patients with ovarian carcinoma who were treated with platinum based chemotherapy at the National Cancer Institute (NCI) in Egypt during the period 7/2016- 7/2018. We evaluated the expression of ER, AR, and Excision repair cross-complementation group 1 enzyme (ERCC1) by immunohistochemistry. Expression profiles were compared to clinical, histologic and prognostic factors, the clinical outcome and survival. All patients received platinum containing chemotherapy regimen. Result : Of the 77 patients with ovarian cancer, 66.2 % (51/77) were ERCC1-positive, 49.4 % (38/77) were AR positive & 75.3 % (58/77) were ER positive. Platinum resistance was found in eight of the tumors with positive ERCC1 protein expression compared with two among the patients with negative tumor staining for ERCC1 (P = 0.643). There was significant association between ER & AR expression and pathological subtypes (p = 0.004, 0.007) respectively. There were no significant association between ER, AR& ERCC1 expression and PFS (P = 0.447,P = 0.162, P = 0.508 respectively) or OS (P = 0.781, P = 0.569, P = 0.381 respectively). Based on Cox proportional hazards regression analysis ERCC1, ER &AR were not independent factors affecting the prognosis of patients with ovarian carcinoma. Conclusion : These results demonstrate that positive ERCC1 expression is not associated with clinical resistance to platinum-based chemotherapy, ERCC1, AR& ER expression are not independent factors affecting the prognosis of patients with epithelial ovarian tumors and not associated with survival benefits. J. Med. Invest. 67 : 391-398, August, 2020.

背景与目的

卵巢癌通常预后较差。因此，迫切需要一种合理的方法来识别可能从治疗中获益的患者。切除修复交叉互补基因 1 酶（ERCC1）已被提议作为预测铂类化疗临床耐药的分子标志物。甾体激素受体是几种起源的肿瘤组织中预后和预测行为的重要决定因素。本研究旨在探讨卵巢癌患者 ERCC1、ER 和 AR 的表达谱及其与患者预后的关系。方法：这是一项前瞻性研究，纳入了 2016 年 7 月至 2018 年 7 月在埃及国家癌症研究所（NCI）接受铂类化疗的 77 例卵巢癌患者。我们通过免疫组织化学评估 ER、AR 和切除修复交叉互补基因 1 酶（ERCC1）的表达。将表达谱与临床、组织学和预后因素、临床结局和生存进行比较。所有患者均接受含铂化疗方案。结果：在 77 例卵巢癌患者中，66.2%（51/77）为 ERCC1 阳性，49.4%（38/77）为 AR 阳性，75.3%（58/77）为 ER 阳性。与 ERCC1 蛋白表达阴性肿瘤相比，8 例 ERCC1 阳性肿瘤中发现铂类耐药，而 ERCC1 肿瘤染色阴性患者中发现 2 例（P=0.643）。ER 和 AR 表达与病理亚型有显著相关性（P=0.004，0.007）。ER、AR 和 ERCC1 表达与 PFS（P=0.447，P=0.162，P=0.508）或 OS（P=0.781，P=0.569，P=0.381）均无显著相关性。基于 Cox 比例风险回归分析，ERCC1、ER 和 AR 不是影响卵巢癌患者预后的独立因素。结论：这些结果表明，ERCC1 阳性表达与铂类化疗的临床耐药无关，ERCC1、AR 和 ER 表达不是影响上皮性卵巢肿瘤患者预后的独立因素，与生存获益无关。J. Med. Invest. 67：391-398，2020 年 8 月。