鼻咽癌患者ERCC1表达水平及强度与其化疗效果及预后的关系探讨

Exploration of the Relationship between the Expression Level and Intensity of ERCC1 in Patients with Nasopharyngeal Carcinoma and Their Chemotherapy Efficacy and Prognosis

目的:探讨鼻咽癌(NPC)患者切除修复交叉互补基因1(ERCC1)表达水平及强度与其化疗效果及预后的关系。方法:以2018年1月-2020年6月经上饶市人民医院肿瘤科收治的NPC患者78例做回顾性研究,均接受2个周期诱导化疗后行同步放化疗,收集患者病灶组织标本行免疫组化SP法测定ERCC1表达水平,分ERCC1阳性组及ERCC1阴性组,且ERCC1阳性组按强度予以亚组分组,分为弱阳性组、中度阳性组及强阳性组,比较ERCC1表达水平及强度与放化疗效果的关系,进行长期随访,采用Kaplan-Meier法(log-rank)绘制生存曲线分析ERCC1表达水平及强度与预后的关系。结果:两组性别、年龄、分期及美国东部肿瘤协作组(ECOG)评分比较,差异均无统计学意义(P>0.05);ERCC1阴性组客观缓解率(ORR)、疾病控制率(DCR)依次为67.86%、92.86%,与ERCC1阳性组ORR(36.00%)、DCR(70.00%)相比均更高,差异均有统计学意义(P<0.05);三组ORR、DCR比较,差异均无统计学意义(P>0.05);经Kaplan-Meier法绘制生存曲线显示:ERCC1阴性组3年生存率高于ERCC1阳性组(P<0.05)。结论:ERCC1表达阴性NPC患者化疗效果较佳,预后较好。

Objective:To investigate the relationship between the expression level and intensity of excision repair cross complementing gene 1(ERCC1)and the chemotherapy effect and prognosis in patients with nasopharyngeal carcinoma(NPC).Method:A retrospective study was conducted on 78 NPC patients admitted to the Oncology Department of Shangrao People's Hospital from January 2018 to June 2020.All of them received two cycles of induction chemotherapy followed by concurrent radiotherapy and chemotherapy.The focus tissue samples of patients were collected for immunohistochemical SP method to determine the expression level of ERCC1,which were divided into ERCC1 positive group and ERCC1 negative group.The ERCC1 positive group was divided into subgroups according to intensity,which were divided into weak positive group,moderate positive group and strong positive group,the relationship between the expression level and intensity of ERCC1 and the effectiveness of radiotherapy and chemotherapy were compared,long-term follow-up was conducted,and Kaplan-Meier method(log-rank)was used to draw survival curves to analyze the relationship between the expression level and intensity of ERCC1 and prognosis.Result:There were no statistically significant differences in gender,age,staging and ECOG score between the two groups(P>0.05);the ORR and DCR of the ERCC1 negative group were 67.86%and 92.86%respectively,which were higher than 36.00%and 70.00%of the ERCC1 positive group,with statistically significant differences(P<0.05);there were no statistically significant differences in ORR and DCR among the three groups(P>0.05);the three years survival rate of the ERCC1 negative group was higher than that of the ERCC1 positive group(P<0.05).Conclusion:Patients with negative ERCC1 expression in NPC have better chemotherapy efficacy and prognosis.