切除修复交叉互补基因1在预测食管鳞癌放化疗反应及预后中的意义

The clinical significance of ERCC1 in predicting the response to platinum-based chemoradiotherapy and prognosis of esophageal squamous cell carcinoma

目的:研究切除修复交叉互补基因1(ERCC1)在食管鳞癌中的表达及其与食管鳞癌患者临床病理特征、食管鳞癌原发灶放化疗反应及预后的相关性。方法:采用免疫组织化学S-P法检测同期放化疗之前内镜下活检的食管鳞癌原发灶中ERCC1表达情况,并用χ2检验或Fisher精确概率方法分析ERCC1表达与临床病理特征之间的关系及其与食管癌放化疗反应的关系,Kaplan-Meier法计算生存率和绘制生存曲线并行log-rank检验。结果:食管鳞癌组织中ERCC1高表达47例(48.0%),低表达51例(52.0%),ERCC1表达水平与临床病理特征均无关(均P>0.05);ERCC1高表达组放化疗缓解率(CR+PR)为53.2%,低表达组放化疗缓解率(CR+PR)为58.8%,两组间的放化疗有效率无统计学差异(P=0.575);根治性放化疗组中,ERCC1高表达患者中位总生存期为15个月,ERCC1低表达患者中位总生存期为21个月,两组患者的总生存期无统计学差异(P=0.141);术前放化疗组中,ERCC1高表达患者中位总生存期为15个月,ERCC1低表达患者中位生存期为41个月,两组患者的总生存期无统计学差异(P=0.431)。结论:ERCC1表达情况可能与食管鳞癌临床病理特征、放化疗反应及预后无明显相关性,ERCC1在食管鳞癌中的预测及预后作用有待进一步研究。

Objective To investigate the expression of ERCC1 in esophageal squamous cell carcinoma （ESCC）, and to study the relationship between ERCC1 and the clinical pathologic characteristics and prognosis of ESCC patients who received chemoradiotherapy （CRT）. Methods The expression of ERCC1 in ESCC was determined by immunohistochemistry （IHC）. Results ERCC1 was highly expressed in 47 （48.0%） patients and lowly expressed in 51 （52.0%） patients. The level of ERCC1 was not correlated with clinical pathologic characteristics （All P 〉 0.05）. The remission rate was 53.2% in ERCC1 higher-expressed group and was 58.8% in ERCC1 lower-expressed group （P = 0.575）. In the definitive CRT group, the median overall survival of ERCC1 higher-expressed patients was 15 months, and that of ERCC1 lower-expressed patients was 21 months （P = 0.141）. In the CRT followed by surgical group, the median overall survival of ERCC1 higher-expressed patients was 15 months, and that of ERCC1 lower-expressed patients was 41 months （P = 0.431）. Conclusion The expression of ERCC1 may not be correlated with clinicopathologic factors, the response of ESCC to CRT, and prognosis. The predicting and prognostic significance of ERCC1 in ESCC should be further explored.