ERCC-1蛋白在局部晚期宫颈癌中表达及其临床意义

Expression of ERCC-1 protein and its clinical implication in locally advanced cervical cancer

目的 研究ERCC-1蛋白在局部晚期宫颈癌组织中的表达及与放化疗疗效的关系。方法 采用免疫组化法对2007—2011年间收治的88例局部晚期宫颈癌组织ERCC-1蛋白进行检测,根据免疫反应强弱将其分为高表达组（48例）,低表达组（40例）。3DCRT过程中同步顺铂每周40 mg/m2。ERCC-1蛋白表达与宫颈癌临床病理因素关系采用χ2检验,Kaplan-Meier行生存分析并Logrank检验,采用Cox模型多因素预后分析。结果 ERCC-1蛋白高表达组宫颈癌患者总有效率（CR＋PR）为81%（39/48）,ERCC-1低表达组（CR＋PR）为85%（34/40）（P=0.641）。ERCC-1蛋白表达与有无复发、转移相关（P=0.043、0.043）。ERCC-1蛋白高表达组与低表达组5年生存率分别为42%和65%（P=0.029）。结论 ERCC-1蛋白高表达组较ERCC-1低表达组更易出现局部复发、远处转移。ERCC-1蛋白表达状态可能成为预测宫颈癌预后的生物学指标之一,对患者预后的判断有一定指导意义。

Objective To examine the protein expression of the nucleotide excision repair gene （ERCC-1） in patients with locally advanced cervical cancer and its relationship with the efficacy of radiotherapy and chemotherapy. Methods The expression of ERCC-1 protein in 88 patients with locally advanced cervical cancer treated in our hospital between 2007-2011 was measured using immunohistochemistry （IHC）. The patients were divided into high-expression group （n=48） and low-expression group （n=40） based on the fluorescence intensity on the IHC staining. All patients received cisplatin （40 mg/m2 per week） during radiotherapy. The relationship between ERCC-1 protein expression and the clinicopathological factors of cervical cancer was analyzed using the chi-square test. Survival was calculated using the Kaplan-Meier method and compared by the log-rank test. Multivariate prognostic analysis was performed using the Cox model. Results The overall response rate （CR＋PR） was 81%（39/48） in the high-ERCC-1 expression group and 85%（34/40） in the low-ERCC-1 expression group （P=0.641）. ERCC-1 protein expression was associated with recurrence and metastasis （P=0.043,0.043）. The 5-year survival rate was significantly higher in the low-ERCC-1 expression group than in the high-ERCC-1 expression group （65% vs. 42%, P=0.029）. Conclusions Patients with high ERCC-1 protein expression are more likely to have local recurrence and distant metastasis than those with low ERCC-1 protein expression. ERCC-1 protein expression may be a clinically significant biomarker for predicting the prognosis of cervical cancer patients.