核苷酸切除修复交叉互补基因1 mRNA表达与非小细胞肺癌铂类化疗患者预后的相关性

Prognostic significance of ERCC1 mRNA expression in patients with non-small cell lung cancer receiving platinum-based chemotherapy

目的探讨核苷酸切除修复交叉互补基因1（ERCC1）mRNA表达与非小细胞肺癌（NSCLC）铂类化疗患者临床病理特征的关系及其预后意义。方法采用实时荧光定量逆转录聚合酶链反应（RT-PCR）方法，检测NSCLC石蜡包埋组织中ERCC1 mRNA的表达水平，并比较其表达水平与NSCLC铂类化疗患者临床病理特征和生存时间之间的关系。结果61例NSCLC患者中，ERCC1 mRNA的中位表达量为0.48。ERCC1 mRNA表达与NSCLC患者临床病理特征无关。ERCC1 mRNA低表达（ 〈0.35）患者经铂类药物化疗后的无进展生存时间为14.3个月，而高表达者为8.0个月，差异有统计学意义（P=0.028）。ERCC1 mRNA低表达（〈0.28）患者的总生存时间为28.4个月，而高表达者为12.9个月，差异有统计学意义（P=0.0064）。Cox多因素回归分析显示，ERCC1 mRNA表达水平是影响NSCLC患者预后的独立因素。结论ERCC1 mRNA的表达水平可以作为以铂类为基础药物化疗的NSCLC患者预后的独立预测因素，ERCC1 mRNA低表达的NSCLC患者经铂类化疗后，总生存时间明显延长，为制定NSCLC个体化的化疗方案提供了重要信息。

Objective To investigate the correlation of the mRNA expression level of excision repair cross-complementing group 1 （ERCC1） gene with clinicopathological parameters and clinical outcome in patients with non-small cell lung cancer （NSCLC） receiving platinum-based chemotherapy. Methods The mRNA expression of ERCC1 in formalin-fixed paraffin-embedded primary tumor specimens was measured by real-time quantitative reverse transcriptase polymerase chain reaction. The association between ERCC1 expression levels and clinicopathological parameters in NSCLC patients was analyzed. Results The median value of ERCC1 mRNA expression level compared with β-actin in tumor specimens of 61 NSCLC patients was 0.48. There was no correlation between ERCCI expression and clinicopathological parameters. Patients with low expression of ERCCI mRNA （ less than 0.35, 0.28, respectively） had a significantly longer median time to progression （TTP） （ 14.3 vs. 8.0 months, P = 0. 028 ） and overall survival （OS） （28.4 vs. 12.9 months, P = 0.0064） than those with high expression. Multivariate analysis showed that a low ERCC1 mRNA expression was an independent factor for OS. Conclusion Our findings suggest that intratumoral ERCC1 mRNA expression level, although is uncorrelated with clinicopathological parameters, is an independent predictive marker for survival of the patients with NSCLC receiving platinum-based chemotherapy, and may provide critical information for personalized chemotherapy.