卵巢癌患者循环肿瘤细胞中ERCC1表达与铂类药物敏感性的关系

Relationship between ERCC1 expression of circulating tumor cell and sensitivity to platinum in patients with ovarian cancer

目的研究上皮性卵巢癌(epithelial ovarian cancer,EOC)患者外周血循环肿瘤细胞(circulating tumor cell,CTC)中切除修复交叉互补基因1(excision repair cross-complementation group 1,ERCC1)表达与铂类药物敏感性的关系。方法以2015年3月-2017年6月本院诊治的60例EOC患者为研究对象,收集手术后化疗前及3个疗程化疗(卡铂/紫杉醇)后1周内患者外周血,利用纳米滤膜结合RNA原位杂交技术分离检测CTC及ERCC1+CTC,分析ERCC1+CTC与临床特征、铂类药物敏感性的关系。结果 60例患者中83.3%(50例)检测出CTC,60%(36例)检测出ERCC1+CTC。将36例ERCC1+CTC患者按照化疗前后ERCC1+CTC数目变化分为化疗后ERCC1+CTC数目升高组(ERCC1+CTC-H组,12例)和ERCC1+CTC数目未升高组(ERCC1+CTC-L组,24例),两组年龄、家族史、病理类型、腹水情况、腹水细胞学情况、残余病灶、FIGO分期等临床特征无统计学差异(P均>0.05),ERCC1+CTC-L组中62.5%(15例)铂类药物敏感,ERCC1+CTC-H组中16.7%(2例)铂类药物敏感,两组差异有统计学意义(P<0.05)。结论外周血循环肿瘤细胞ERCC1阳性可预测铂类药物敏感性。

Objective To study the relationship between the expression of excision repair cross complementation group 1（ERCC1） in circulating tumor cell（CTC） in peripheral blood of patients with epithelial ovarian cancer（EOC） and the sensitivity to platinum. Methods A total of 60 EOC patients in Chinese PLA General Hospital from March 2015 to June 2016 were enrolled. Peripheral blood of patients was collected before postoperative chemotherapy and within a week after the three courses of chemotherapy（carboplatin/paclitaxel）. The Nanofiltration membrane and RNA in situ hybridization technique was used to separate and detect the CTC and ERCC1-positive CTC. The relationship between ERCC1-positive CTC and the sensitivity to platinum was analyzed. Results Of the 60 cases, CTC was observed in 50 cases（83.3%） and ERCC1-positive CTC in 36 cases（60%）. According to the quantitative change of ERCC1 ＋ CTC before and after chemotherapy, the 36 patients were divided into elevated ERCC1 ＋ CTC group（ERCC1 ＋ CTC-H group,12 cases） and non-elevated ERCC1 ＋ CTC group（ERCC1 ＋ CTC-L group, 24 cases）. No significant difference was between the two groups in age, family history, histology, ascites, ascites cytology, residual tumor, FIGO stage（P〈0.05）. There were 15 cases（62.5%） in ERCC1 ＋ CTC-L group and 2 cases（16.7%） in ERCC1 ＋ CTC-H group were sensitive to platinum, with statistically significant difference between the two groups（P〈0.05）. Conclusion The ERCC1 expression of CTC can predict the sensitivity to platinum.