切除修复交叉互补组1、核糖核苷酸还原酶亚单位表达对非小细胞肺癌含铂新辅助化疗方案的影响

Impact of ERCC1 expression in new neo-adjuvant chemotherapy containing platinum before operation in stage m NSCLC

目的通过对Ⅲ期非小细胞肺癌（NSCLC）新辅助化疗疗效分析，探讨切除修复交叉互补组1（ERCC1）、核糖核苷酸还原酶亚单位（RRM1）表达在含铂方案化疗中所起的指导作用。方法80例病理证实为NSCLC患者接受2周期新辅助化疗，化疗前均用分支DNA一液相芯片法检测ERCC1、RRM1表达，并均采用吉西他滨＋顺铂（GP）方案；疗效根据WHO标准确定，CT增强扫描显示达完全缓解或部分缓解者为有效或稳定，而扫描显示进展者为无效。结果80例NSCLC患者：ERCC1、RRM1均低表达（A组）25例中20例有效，有效率为80．O％，ERCC1低表达、RRM1高表达（B组）23例中14例有效，有效率为60．9％，ERCC1高表达、RRM1低表达（C组）20例中10例有效，有效率50．0％，ERCC1、RRM1均高表达（D组）12例中4例有效，有效率33．3％，4组比较差异有统计学意义（x2=7．81，P〈0．05），且A组疗效明显高于其他3组，B、C组亦高于D组，差异均有统计学意义（P均〈0．05）。结论ERCC1、RRM1检测对NSCLC新辅助化疗方案选择有指导意义，值得被广泛推广应用于NSCLC外科个体化治疗。

Objective We analyzed the curative effect of ERCC1 and RRMI expression on the Neo- adjuvant Chemotherapy of stage m NSCLC to investigate the guiding function of ERCC1 and RRM1 expression in chemotherapy regimen containing platinum. Methods Branch DNA -liquid phase chip methods were used to detect ERCC1 and RRM1 expressions before chemotherapy in 80 cases of stage m NSCLC confirmed by pathology. All patients received 2 periods Neo-adjuvant Chemotherapy with GP regimen. According to WHO efficacy appraisal standard,the Enhanced Scan of CT showing reaching complete remission or partial remission was effective or stable, otherwise the progression was considered ineffective. Results For the 80 cases of stage m NSCLC ,the treatment for 20 of the 25 patients with low expressions of both ERCC1 and RRM1 were effective with an effective rate of 80. 0% ; The treatment for 14 of the 23 patients with low expressed ERCC1 and high expressed RRM1 were effective with an effective rate of 60. 9% ;The treatment for 10 of the 20 patients with high expressed ERCC1 and low expressed RRM1 were effective with an effective rate of 50.0% ;and the treatment for 4 of the 12 patients with both high expression were effective with an effective rate of 33.3%. The difference of effective rates among the four groups had statistical significance （ X^2 = 7.81, P 〈 0. 05 ） with group A having significantly higher rate than the other three groups and group B and group C having significantly higher rate than group D （P 〈 0. 05 ）. Conclusion ERCC1 detection has guiding significance on the regimen selection of NSCLC Neo-adjuvant Chemotherapy. It was worthwhile to use ERCC1 detection widely in the individualized treatment of the stage Ⅲ NSCLC before surgery.