BRCA1、ERCC1、β-tubulinⅢ和RRM1的表达对Ⅱ～Ⅳ期非小细胞肺癌术后化疗药物确定及生存趋势的影响

The effects of BRCA1,ERCC1,β-tubulinⅢ,RRM1 on the determination of chemotherapy drugs and postoperative survival trend in patients with non-small cell lung cancer at Ⅱ～Ⅳ stage

目的研究BRCA1、ERCC1、β-tubulinⅢ和RRM1的表达对Ⅱ～Ⅳ期非小细胞肺癌术后化疗药物的确定以及生存趋势的影响。方法选取2013年6月至2015年7月进行手术治疗的93例非小细胞肺癌患者,采用免疫组化法对93例手术切除同时采取辅助化疗的非小细胞肺癌患者的肿瘤组织进行BRCA1、ERCC1、β-tubulinⅢ和RRM1水平的检测,分析其在患者组织中的表达与相关指标、临床病理等因素的关系,通过随访分析其与患者生存期、2年生存率的相关性,以及与患者不同辅助化疗药物选择的关系。结果本研究患者组织中BRCA1在Ⅱ～Ⅳ期非小细胞肺癌患者肿瘤组织中的表达与统计的临床病理特征无显著差异(P> 0. 05)。ERCC1的阳性表达与患者的淋巴结转移有密切关系(P <0. 05);β-tubulinⅢ在较年轻及鳞癌类型患者中的表达量较高,与年长(> 60岁)及腺癌患者中的表达均有显著差异(P <0. 05); RRM1与统计的临床病理特征无显著的相关性(P> 0. 05)。BRCA1、ERCC1、β-tubulinⅢ及RRM1阳性表达患者平均总生存期(月)均显著短于阴性患者,2年生存率也明显低于阴性患者(P <0. 05)。RRM1与吉西他滨辅助化疗相关(P <0. 05),β-tubulinⅢ与多西他赛和长春瑞滨辅助化疗方案的选择具有一定的相关性(P <0. 05),而BRCA1、ERCC1、RRM1与紫杉醇辅助化疗方案的选择具有一定的相关性(P <0. 05)。结论通过免疫组织化学的方法对BRCA1、ERCC1、β-tubulinⅢ和RRM1的表达水平进行检测,在一定程度上对Ⅱ～Ⅳ期非小细胞肺癌患者的术后辅助化疗药物的选择具有一定的指导作用,并能初步预测患者术后的生存趋势。

Objective To investigate the effects of BRCA1,ERCC1,β-tubulinⅢ,RRM1 effects of BRCA1,ERCC1,β-tubulinⅢ,RRM1 on the determination of chemotherapy drugs and postoperative survival trend in patients with non-small cell lung cancer (NSCLC) at Ⅱ~Ⅳ stage. MethodsA total of 93 patients with NSCLC at Ⅱ~Ⅳ stage who were treated in our hospital from June 2013 to July 2015 were enrolled in the study. The levels of BRCA1,ERCC1,β-tubulinⅢ,RRM1 in tumor tissues were detected by using immunohistochemical method to analysis the relationship between the expression levels of the indexes and clinical pathological factors.And the correlation between the expression levels of the indexes and survival time,2-year survival rate of patients was analyzed, Moreover the the correlation between the expression levels of the indexes and the selection of different chemotherapeutics was analyzed. ResultsThere were no significant differences in the expression levels of BRCA1 in tumor tissues and clinical pathological characteristics of patients with NSCLC at Ⅱ~Ⅳ stage ( P >0.05). The positive expression of ERCC1 was closely correlated with lymph node metastasis of patients ( P <0.05).Moreover the expression levels of β-tubulinⅢ in younger patients and the patients with squamous cell carcinoma adenocarcinoma were higher ( P <0.05),there were significant differences in the expression levels between younger patients as well as the patients with squamous cell carcinoma and the older patients as well as the patients with adenocarcinoma ( P <0.05).However there were no significant differences between the expression levels of RRM1 and clinical pathological characteristics ( P >0.05).Moreover the total survival duration (month) and 2-year survival rate in patients with positive expressions of BRCA1,ERCC1,β-tubulinⅢ and RRM1 were significantly less than those of patients with negative expressions of BRCA1,ERCC1,β-tubulinⅢ( P <0.05). In addition RRM1 was associated with gemcitabine chemotherapy ( P <0.05),and β-tubulinⅢ was related with docetaxel and vinorelbine chemotherapy scheme ( P <0.05),however, BRCA1,ERCC1 and RRM1 were correlated with paclitaxel adjuvant chemotherapy ( P <0.05). ConclusionThe detection of expression levels of BRCA1,ERCC1,β-tubulinⅢ and RRM1 by immunohistochemical method can direct the chemotherapeutics selection and can forecast the postoperative survival trend of patients with NSCLC after operation.