吉西他滨联合顺铂化疗对非小细胞肺癌患者ERCC1基因表达的影响

Effect of Gemcitabine Combined with Cisplatin on the Expression of ERCC1 in Patients with Non-small Cell Lung Cancer

目的探讨吉西他滨联合顺铂(GP方案)化疗对非小细胞肺癌(NSCLC)的疗效及其与患者ERCC1基因表达的相关性。方法选取我院收治的初次确诊的晚期NSCLC患者50例,采用实时荧光定量PCR技术检测纳入患者的ERCC1表达情况,其中ERCC1(+)30例,ERCC1(-)20例。所有患者均采用GP方案化疗,并进行临床随访,分析ERCC1表达与NSCLC化疗耐药的相关性。结果 ERCC1(+)组客观缓解率为32%,ERCC1(-)组为50%,差异有统计学意义(P<0.05);ERCC1(+)表达率为56%,其表达与患者性别、组织学类型、年龄、临床分期及淋巴结转移无相关性(P>0.05),而与吸烟指数具有相关性(P<0.05);ERCC1(+)组1年、3年生存率分别为49.01%、23.42%,ERCC1(-)组分别为67.06%、38.57%,ERCC1(-)组生存率明显高于ERCC1(+)组,差异有统计学意义(P<0.05);ERCC1(+)组中位生存期为18个月,ERCC1(-)组为30个月,差异有统计学意义(P=0.0339);治疗后ERCC1(-)组CD3、CD4、CD8、CD4/CD8显著高于ERCC1(+)组(P<0.05)。结论含铂类药物化疗方案对于NSCLC ERCC1(-)患者的预后较好。

Objective To investigate efficacy of gemcitabine plus cisplatin (GP) chemotherapy and its correlation with the expression of excision repair cross-complementing gene 1 (ERCC1) in non-small cell lung cancer. Methods The firstly confirmed 50 cases of patients with advanced non small cell lung cancer in our hospital were select out for this study. Real-time fluorescent quantitative PCR was applied to detect the ERCC1 expression. According to the detection results, there were 28 cases in ERCC1(+) group and 22 cases in ERCC1(-) group. All patients were treated with gemcitabine combined with cisplatin chemotherapy. All were followed up to analyze the correlation between ERCC1 expression and drug resistance of non-small cell lung cancer. Results In ERCC1(+) group, GP chemotherapy response rate was 32%, while it was 50% in ERCC1(-) group;the difference between the two groups was statistically significant (P<0.05). The ERCC1(+) expression rate was 56%. The ERCC1 expression showed a significant correlation with smoking (P<0.05), but no correlation with gender, age, histological type, clinical stage and lymph node metastasis (P>0.05). In the ERCC1(+) group, the 1- and 3-year survival rates were respectively 49.01% and 23.42%. Whereas in ERCC1(-) group, the 1- and 3-year survival rates were 67.06% and 38.57% respectively. The ERCC1(-) group had significantly higher survival rate than ERCC1(+) group (P<0.05). The median survival time was 18 months in ERCC1(+) group, but it was 30 months in ERCC1(-) group;there was significant difference between two groups (P=0.0339). After treatment, patients of ERCC1(-) group had higher levels of CD3, CD4, CD8 and CD4/CD8 than those of ERCC1(+) group (P<0.05). Conclusion Platinum-based chemotherapy had a good benefit to the prognosis of non-small cell lung cancer patients with low expression of ERCC1.