ERCC1和BRCA1与非小细胞肺癌完全切除术后铂类化疗及预后的临床研究

Expressions of ERCC1 and BRCA1 and clinical response to platinum-based adjuvant chemotherapy in completely resected non-small cell lung cancer

目的:探讨ERCC1和BRCA1在ⅢA-N2期非小细胞肺癌(NSCLC)中的表达及其与铂类药物辅助化疗的相关性,为NSCLC个体化辅助化疗提供依据。方法:免疫组化方法检测ERCC1、BRCA1在89例手术完全切除并行含铂辅助化疗的ⅢA-N2期NSCLC中的表达。应用统计学软件SPSS 16.0行数据处理,回顾性分析ERCC1和BRCA1的表达与临床、病理各因素及患者预后的关系。结果:ⅢA-N2期NSCLC中ERCC1和BRCA1阳性表达率分别为46.1%和59.6%。ERCC1和BRCA1的表达与铂类化疗明显相关,表达阴性者在含铂化疗组有更长的无瘤生存期(P=0.000,P=0.022)和总生存期(P=0.000,P=0.009)。ERCC1和BRCA1表达均阴性者在含铂化疗组有更长的无瘤生存期(P=0.000)和总生存期(P=0.000)。结论:ERCC1表达阳性、组织病理分化低、全肺切除是影响ⅢA-N2期NSCLC预后的危险因子。ERCC1和BRCA1的表达与铂类化疗相关,表达均阴性者预后较好。

OBJECTIVE：To retrospectively analyze the expressions of ERCC1 and BRCA1 in completely resected staged ⅢA-N2 non-small cell lung cancer（NSCLC）,and examine the association between the molecular markers and response to adjuvant chemotherapy.METHODS：Immunohistochemical analysis was used to determine the expressions of ERCC1 and BRCA1 proteins in completely resected staged ⅢA-N2 NSCLC.The correlation between the expressions of these markers and the clinicpathologic factors and prognoses were analyzed.All the analyses were performed with the use of SPSS 16.0.RESULTS：Among 89 cases,the positive expression rates of ERCC1 and BRCA1 were 46.1% and 59.6%,respectively.The expressions of ERCC1 and BRCA1 were associated with platinum-based regimens.Platinum-based adjuvant chemotherapy significantly prolonged the disease-free survival（DFS）（P=0.000,P=0.022） and overall survival（OS）（P=0.000,P=0.009） among patients with ERCC1 and BRCA1 negative tumors,and also prolonged DFS（P=0.000） and OS（P=0.000） among the patients with both ERCC1-negative and BRCA1-negative.CONCLUSIONS：ERCC1-positive expression,poorly differentiated and undifferentiated histological grade,and pneumonectomy are independent prognostic factors.The expressions of ERCC1 and/or BRCA1 are associated with platinum-based regimens.Low expressions of these markers have better outcomes.