吉西他滨对非小细胞肺癌患者化疗疗效与其病理组织基因表达的相关性

Chemotherapeutic effect of gemcitabine for non-small cell lung cancer patients and the correlation with the expression of gene in pathological tissue

目的观察吉西他滨对非小细胞肺癌患者化疗疗效,分析化疗疗效与病理组织核糖核苷酸还原酶M1(RRM1)和核苷酸切除修复交叉互补基因1(ERCC1)表达的相关性。方法收集96例非小细胞肺癌患者的临床资料,所有患者均经吉西他滨+顺铂化疗,用免疫组化法检测化疗前患者病理组织RRM1、ERCC1的表达情况,化疗3周后分析病理组织RRM1、ERCC1表达情况与患者临床特征,化疗疗效相关性。结果化疗后,RRM1阳性表达率为60.42%;ERCC1阳性表达率为43.75%;非小细胞肺癌患者病理组织RRM1及ERCC1阳性表达与患者性别及吸烟情况有显著相关性(P<0.05或P<0.01),而与患者年龄、临床分期无显著相关性(均P>0.05);病理组织RRM1/ERCC1+/+,-/-,+/-或-/+非小细胞肺癌患者有效率分别为17.95%,74.29%及59.09%,病理组织RRM1/ERCC1-/-非小细胞肺癌患者有效率显著高于+/+,+/-或-/+者(P<0.05或P<0.01);且RRM1/ERCC1+/-或-/+者有效率显著高于RRM1/ERCC1+/+者(均P<0.05)。经Spearman相关性分析显示,非小细胞肺癌患者病理组织RRM1、ERCC1阴性表达均与患者化疗疗效显著正相关(r=0.248,0.306,均P<0.05)。结论吉西他滨化疗对非小细胞肺癌患者具有一定的临床疗效,其与患者病理组织RRM1、ERCC1蛋白阴性表达具有显著正相关性,两者可作为非小细胞肺癌化疗疗效的评估指标。

Objective To explore the chemotherapeutic effect of gemci- tabine for non -small cell lung cancer patients and analyzed the correla- tion of chemotherapeutic effect with ribonucleotide reductase M1 （ RRM1 ） , excision repair cross - complementing 1 （ ERCC1 ）. expression in pathological tissue. Methods The clinical data of 96 non - small cell lung cancer patients were selected. All patients were treated with gemci- tabine ＋ cisplatin chemotherapy, and the RRM1, ERCC1 expression in pathological tissue were detected by immunohistochemical method at 3 weeks after chemotherapy, the correlation of clinical features with chemo- therapeutic effect were analyzed. Results The positive expression rates of RRMI and ERCC1 were 60. 42% , 43.75%. The positive expression of non -small cell lung cancer patients pathological tissue RRM1, ERCC1 had significant correlation with the gender and smoking status（P 〈0.05 or P 〈0.01 ）, while had no correlation with the age and clinical stages （all P 〉0.05）. The effective rates of patients with pathological tissue RRM1/ERCC1 ＋/＋, -/- , ＋/- or -/＋ were 17.95%, 74. 29% and 59.09%, and the effective rates of patients with pathological tissue RRM1/ERCC1 -/- were higher than ＋/＋ , ＋/- or -/＋ （P 〈 0. 05 or P 〈 0. 01 ）, and the effective rates of patients with pathological tissue RRM1/ERCCI ＋/- or -/＋ were higher than RRM1/ERCC1 ＋/＋ （all P 〈0.05）. Spearman correlation analysis showed that, the negative expression of non -small cell lung cancer patients anthological tissue RRMI, ERCCI had significant posi- tive correlation with chemotherapeutic effect （ r = 0. 248,0. 306, all P 〈 0.05 ）. Conclusion Gemcitabine has a certain clinical effect in the treatment of non - small cell lung cancer patients, and the clinical effect had significant positive correlation with the negative expression of non - small cell lung cancer patients anthological tissue RRMI, ERCC1 protein, which can act as the evaluation index for the chemotherapeutic effect.