新辅助化疗对非小细胞肺癌组织ERCC1和BRCA1表达影响

目的探讨非小细胞肺癌（NSCLC）组织核苷酸切除修复基因1（ERCC1）和乳癌易感基因1（BRCA1）的表达以及新辅助化疗对两者表达的影响。方法应用免疫组化PV二步法检测110例NSCLC组织（50例术前行新辅助化疗,60例行常规手术而术前未经化疗）ERCC1、BRCA1的表达。结果ERCC1主要在NSCLC组织细胞核表达,细胞浆有少量表达,总阳性表达率为59.09%。BRCA1在细胞核表达,总阳性表达率为74.55%。ERCC1、BRCA1表达强度与性别、年龄、组织学类型、肿瘤细胞分化程度、临床分期及有无淋巴结转移均无关（u=-1.557～-0.032,H=0.003～3.151,P〉0.05）。新辅助化疗组ERCC1、BRCA1总阳性表达率为68.00%、80.00%,单纯手术组为51.67%、70.00%,两组比较差异有显著性（u=-2.365、-3.011,P〈0.05）。ERCC1与BRCA1的表达强度呈显著正相关（r=0.264,P〈0.01）。结论新辅助化疗可以影响NSCLC组织中ERCC1、BRCA1的表达,从而影响肿瘤对顺铂化疗的敏感性,在肿瘤化疗中应予重视。

THE EFFECT OF NEOADJUVANT CHEMOTHERAPY ON EXPRESSIONS OF ERCC1 AND BRCA1 IN NON-SMALL-CELL LUNG CANCER

Objective To investigate the expressions of excision repair cross complementing 1 （ERCC1） and breast cancer susceptibility gene 1 （BRCA1） in non-small-cell lung cancer （NSCLC） and the influence of neoadjuvant chemotherapy on them. Methods Expressions of ERCC1 and BRCA1 were detected via immunohistochemistrieal PV method in specimens of NSCLC in 110 patients, of whom, 50 were offered pre-operative neoadjuvant chemotherapy, 60 underwent surgery without pre-operative chemotherapy. Results Expressions of ERCC1 and BRCA1 were mainly found in the nuclei with the total positive rates of 59. 09 % and 74.55%, respectively. The intensity of expressions of ERCC1 and BRCA1 was not related with sex, age, histological type, cell differentiation, clinical stage and with or without lymph node metastasis （u=-1. 557--0. 032, H=0. 003-3. 151 ,P〉0.05）. In neoadjuvant-chemotherapy group, the total positive rates of ERCC1 and BRCA1 were 68.00% and 80. 00%, respectively; in nonchemotherapy group, they were 51. 67% and 70. 000%. The difference between the two groups was significant （u=- 2. 365, -3. 011;P〈0.05）. A positive correlation was noted between the expression intensity of ERCC1 and BRCA1 （r= 0. 264, P〈 0. 01）. Conclusion Neoadjuvant chemotherapy may influence the expressions of ERCC1 and BRCA1 in NSCLC tissue and thus affect the sensitivity of cancer to cisplatin.