局部晚期鼻咽癌ERCC1 mRNA表达水平与铂类同期放化疗疗效的相关性研究

Relationship between ERCC1 mRNA expression and platinum-based concurrent chemotherapy in locally advanced nasopharyngeal carcinoma

目的明确鼻咽癌铂类同期放化疗疗效与肿瘤组织中DNA切除修复交叉互补基因1(excision repair cross-complementing gene1, ERCC1)mRNA表达水平的关系。方法选取2012年6月至2013年6月在广西医科大学第四附属医院肿瘤科经活检诊断为鼻咽低分化鳞癌的初治患者,放化疗前通过RT-PCR测量肿瘤组织中ERCC1 mRNA表达水平,所有患者均接受顺铂单药同期放化疗,治疗结束3个月后复查,评估疗效,分析铂类药物化疗短期疗效与ERCC1 mRNA表达水平间的关系。结果共78例患者纳入研究且可评价,其中完全缓解占65.38%,部分缓解占24.36%,疾病稳定占5.13%,疾病进展占5.13%;有效率89.74%,疾病控制率94.87%。ERCC1 mRNA在肿瘤组织的平均表达水平为1.216,患者的年龄、性别和TNM分期与ERCC1 mRNA表达水平间差异均无统计学意义(P>0.05)。放化疗前肿瘤组织中ERCC1 mRNA低表达的治疗有效率明显高于高表达者(P<0.05)。结论 ERCCl mRNA在鼻咽癌组织中的表达水平与铂类同期放化疗短期疗效间呈负相关关系,可预测铂类同期放化疗治疗局部晚期鼻咽癌的效果。

Objective To explore the relationship between the efficacy of platinum concurrent chemotherapy in advanced nasopharyngeal carcinoma and the expression level of excision repair cross-complementing gene1 (ERCC1) mRNA in tumor tissue. Methods A total of 87 untreated patients who were diagnosed as poorly differentiated squamous cell carcinoma of the nasopharyngeal tissue by biopsy from June 2012 to June 2013 in the Fourth Affiliated Hospital of Guangxi Medical University. The expression of ERCC1 mRNA in tumor tissue was measured by reverse transcription polymerase chain reaction (RT-PCR) before chemotherapy. All the patients received Cisplatin-based concurrent chemoradiotherapy. The efficacy was evaluated after the treatment of three months. Results A total of 78 patients were included in this study whose CR, PR, SD and PD reached 65.38%, 24.36%, 5.13% and 5.13% respectively. Effective rate (RR) was 89.74%, and disease control rate (DCR) was 94.87%. The average expression level of ERCC1 mRNA was 1.216. There was no significant difference between the age, sex, TNM stage and ERCC1 mRNA expression. The effective rate of ERCC1 mRNA low expression in tumor tissues before treatment was significantly higher than that of high expression group ( P < 0.05). Conclusions The expression level of ERCC1 mRNA in nasopharyngeal carcinoma negatively correlates with the short-term efficacy of platinum-based concurrent radiochemotherapy for locally advanced nasopharyngeal carcinoma, which might be a useful predictive marker.