联合检测ERCC1、BRCA1、RRM1表达在非小细胞肺癌选择化疗方案中的意义

Significance of protein expression level of ERCC1,BRCA1 and RRM1 in chemotherapy plan for the patients with non-small cell lung cancer

目的:探讨检测非小细胞肺癌组织中ERCC1、BRCA1、RRM1的蛋白表达在化疗方案选择中的临床意义。方法:选取确诊非小细胞肺癌患者120例,随机分为两组。常规化疗组(60例)给予吉西他滨/紫杉醇+顺铂化疗;实验组(60例):化疗前检测ERCC1、RRM1、BRCA1蛋白的表达,选用敏感的化疗药物治疗。比较两组的疗效、无疾病进展时间和生存期。结果:实验组中ERCC1蛋白和BRCA1蛋白表达阳性率为28.33%,RRM1蛋白表达阳性率为51.67%。治疗两周期后评价常规化疗组和实验组的化疗客观缓解率分别是35.00%(21/60),43.33%(26/60),无统计学差异(P>0.05)。两组无疾病进展平均时间、中位时间分别为实验组6.653个月、4.8个月;常规化疗组4.35个月、3.5个月,有统计学意义(P<0.05)。生存分析两组比较差异无统计学意义(P>0.05)。结论:检测ERCC1蛋白、BRCA1蛋白、RRM1蛋白的表达选择化疗方案使非小细胞肺癌患者在临床化疗中获益,可以延长无疾病进展时间。

Objective：To dissuss the clinical significance of protein expression level of excision repair cross com-plementing 1 （ ERCC1 ） , breast cancer susceptibility gene 1 （ BRCA1 ） and ribonucleotide reductase subunit Ml （RRM1） from lung cancer tissue in chemotherapy plan for patients with non - small cell lung cancer （ NSCLC ）. Methods ： Totally 120 patients with NSCLC were selected and randomly divided into the conventional chemotherapy group（n=60） and the experimental group（n=60） according to different chemotherapies. The conventional chemo-therapy group was treated by gemcitabine or paclitaxel combined with cisplation. The experimental group guided pa-tients to choose chemotherapeutics with sensitivity by detecting the protein expression level of ERCC1,BRCA1,RRM1 .The curative effect, progression - free - time and the survival time for two years in the two groups after chemotherapy were compared. Results ： In the experimental group , the protein expression of ERCC1 , BRCA1 and RRM1 were 28. 33% ,28. 33% and 51.67%. There was no statistically significant difference between the two groups on effective rate and the survival on 1 year and 2 years after chemotherapy. The mean and median time to progression - free - time were respectively 6. 653 months,4. 8 months in the experimental group and 4. 35 months,3. 5 months in the conven-tional chemotherapy group,the difference had statistical significance（P 〈0.05）. Conclusion： The detection of ER- CC1 ,BRCA1 and RRM1 protein expression benefits the patients with non - small cell lung cancer which prolongs the progression - free - time.