非小细胞肺癌患者ERCC1蛋白表达与铂类标准方案化疗敏感性的关系研究

ERCC1 protein expression in relation to chemotherapy sensitivity of stage Ⅲ/Ⅳ NSCLC patients treated with cisplatin-based chemotherapy

目的：研究探讨Ⅲ、Ⅳ期非小细胞肺癌（NSCLC）患者癌组织内DNA破坏修复酶-错配切除交叉互补修复酶1（excision repair cross—complementing 1，ERCC1）的表达与铂类标准化疗（sc）方案化疗敏感性的关系。方法：共入选Ⅲ、Ⅳ期NSCLC患者120例，完成试验可评价的53例，对化疗前通过气管镜或经皮肺穿刺的组织学标本ERCC1行免疫组化检测。患者给予4—6周期铂类为基础的SC化疗，对患者化疗后的总生存期（overall survival，OS）、肿瘤进展时间（time to progression，TTP）及化疗后反应率（response rate，RR）进行评价。结果：53例患者中，ERCC1染色阳性27例，阳性率为50．94％。ERCC1阳性组患者化疗后RR、OS及TTP分别为25．9％、（294．78±127．52）天及（183．71±82．07）天，与ERCC1阴性组患者RR53．8％、0S（415．50±204．75）天、TTP（256．92±133．29）天比较，差异均有统计学意义（P值分别为0．038、0．0126和0．019）。结论：ERCC1表达不同可能是化疗方案中铂类药物敏感性差别的重要因素，本研究可为临床上NSCLC患者个体化疗方案（TC）的制定提供参考。

Objective：Aim of this explorative study was to determine the prognostic value of protein expression of the DNA damage repair enzymes Excision Repair Cross-Complementing 1 （ ERCC1 ） for tumour response and survival of non-small-cell lung cancer（NSCLC） patients treated with cisplatin-based chemotherapy. Methods：A total of 120 cases of stage Ⅲ/Ⅳ NSCLC patients were included ,only 55 patients were evaluated. Bronchoscopy tumour biopsies or lung puncture tumour biopsies were assessed by immunohistochemical staining using antibody against ERCC1 before chemotherapy. The patients were treated with 4 to 6 cycles of cisplatin-based chemotherapy （ taxane/cisplatin or vinorelbine/cisplatin）. Chemotherapy tumor response rate （ RR）, overall survival （OS） and time to progression（TIP） were assessed. Results： A positive nuclear staining for ERCC1 was observed in 27 patients, the positive rate was 50. 94 %. The RR, OS and TIP were 25.9%, （294. 78 ± 127. 52） days and （ 183.71 ± 82. 07 ） days in E RCCI positive group respectively, and 53.8%, （415.50 ± 204. 75） days and （256.92 ± 133.29） days in ERCC1 negative group respectively. There were significant difference beween the two groups（ P = 0. 038,0. 0126 and 0. 019 respectively）. Conclusion：The difference expression of the DNA damage repair enzymes ERCC1 might be a molecule marker of chemotherapy sensitivity in NSCLC patients treated with cisplatin-based chemotherapy. The result of this study may provide new sight for tailor chemotherapy （TC） to individual NSCLC patients.