切除修复交叉互补酶1在非小细胞肺癌中的表达及其对术后铂类辅助化疗的影响

Expression of excision repair cross-complementation group 1 in non-small-cell lung cancer and its contribution to Cisplatin-based adjuvant chemotherapy

目的:探讨切除修复交叉互补酶1(ERCC1)在Ⅰ～Ⅲ期非小细胞肺癌(NSCLC)的表达及对术后铂类辅助化疗效果的影响。方法:应用免疫组化SP方法检测59例Ⅰ～Ⅲ期手术切除、术后铂类辅助化疗NSCLC患者的肿瘤组织中ERCC1的表达。采用χ2检验,Kaplan-Meier生存曲线和COX回归分析,比较ERCC1表达对Ⅰ～Ⅲ期NSCLC手术并术后辅助化疗患者的生存期的影响。结果:59例患者中,ERCC1表达阳性组31例(52.5%),手术后辅助化疗的总体生存期为20.4个月;ERCC1表达阴性组28例,生存期为36.7个月。Kaplan-Meier生存曲线显示ERCC1阴性组在阳性组之上;Log-Rank检验,两者生存差异具有统计学意义(P=0.019)。COX多因素回归示TNM分期和ERCC1表达是该组患者的独立预后因子。结论:Ⅰ～Ⅲ期NSCLCERCC1表达阴性组可从铂类辅助化疗中获益,ERCC1可作为独立预后因子。

Objective ： Adjuvant Cisplatin-based chemotherapy improves survival of patients with resected stage Ⅰ - Ⅲ non-small-cell lung cancer （NSCLC） , but there is no validated clinical or biological predictor of the benefit of the therapy. We aimed to investigate the expression of excision repair cross-complementation group 1 （ ERCCI ） in NSCLC patients and its contribution to the effect of Cisplatin-based adjuvant chemotherapy Methods ：We determined the expression of ERCC1 protein by immunohistochemistry in the specimens of 59 NSCLC patients who received surgical resection followed by adjuvant Cisplatinbased chemotherapy, and analyzed the overall survival of the patients by means of χ^2 test, Kaplan-Meier survival curve and COX regression. Results：Positive expression of ERCC1 was found in 30 （52.5%） of the total cases, and negative in 28. The overall survival of the negative group was significantly longer than that of the positive （36.7 mvs 20.4 m, P =0. 019）. COX multivariate analysis showed that negative ERCC1 expression （ hazard ratio = 0. 412, P = 0. 023 ） and lower TNM stage （ hazard ratio = 2. 062, P = 0. 044） were signifieantly favorable factors for overall survival. Conclusion：Patients with resected stage Ⅰ - Ⅲ NSCLC and negative ERCC1 can benefit from adjuvant Cisplatin-based chemotherapy, and the expression of ERCC1 can be an important independent prognostic faetor of NSCLC.