晚期非小细胞肺癌RRM1表达和吉西他滨疗效分析

RRM1 Expression and Efficacy Analysis of Gemcitabine in Advanced Non-small Cell Lung Cancer

目的探讨ⅢB/IV期非小细胞肺癌(NSCLC)RRM1表达与吉西他滨化疗疗效间关系。方法回顾性分析61例接受以吉西他滨化疗的ⅢB/IV期NSCLC临床病理资料。免疫组织化学法检测肿瘤标本RRM1蛋白表达,并对化疗疗效及生存时间进行分析。结果RRM1阳性表达(≥50%阳性染色细胞)率为42.6%(26/61),与性别、年龄、组织类型及临床分期无关。化疗有效率(CR+PR)为34.4%(21/61),其中RRM1高表达患者化疗有效率和控制率分别为19.2%(5/26)和80.8%(21/26),而RRM1低表达患者分别为35.7%(16/35)和100%(35/35)(P=0.031、0.025)。RRM1高表达者有较短的中位OS(10个月)和PFS(6个月),而低表达患者有较长的中位OS(13个月)和PFS(10个月)(P=0.046、0.038)。COX回归分析表明RRM1是晚期NSCLC的独立预后影响因素。结论RRM1高表达NSCLC患者对吉西他滨药物耐药且预后不良。

Objective To investigate the expression of RRM1 protein and the efficacy of gemcitabine in advanced non - small cell lung cancer （NSCLC）. Methods Clinical pathological data of 61 stage ⅢB/Ⅳ NSCLC patients who received gemcitabine were retrospectively analyzed, and their tumor samples were collected. The express on of RRM1 protein in tumor samples was detected by the immunohistochemical methods. The data of therapeutical effect and survival time were collected and analyzed. Results The RRM1 positive staining （≥50 % of stained cel s） accounted for 42.6 % （26/61）. There was no correlation between RRM1 positive expression and age, gender, pathological type and TNM stage. The response rate （CR ＋ PR）was 34.4% （21/61）. Patients with low expression had remarkably higher response rate and control rate to gemcitabine than overexpression RRM1 group, 35.7% ： 19.2, P = 0. 031 and 100% ： 80.8%, P = 0. 025, respectively, Overexpression of RRM1 protein was correlated with shorter median overall survival （10 months ） and progressionfree survival （6 months）, while a low level of expression of RRM1 protein was correlated with longer median overall survival （13 months） and progressionfree survival （10 months）, （P = 0. 046, P = 0. 038）. COX regression analysis revealed that RRM1 was an independent prognostic factor. Conclusions Overexpression of RRM1 in tumor cells is associated with resistance to gemcitabine and a poor prognosis in patients with NSCLC receiving gemeitabine - based chemotherapy.