老年晚期非小细胞肺癌外周血RRM1 表达与吉西他滨疗效及预后的相关性研究

目的 探讨老年晚期非小细胞肺癌（non-small cell lung cancer，NSCLC）外周血中核苷酸还原M1（RRM1）的表达水平与吉西他滨化疗疗效及预后的相关性。方法 通过实时荧光定量聚合酶链反应方法（qRT-PCR）检测40 例老年晚期NSCLC 患者外周血中RRM1 的表达水平，并对临床特征、吉西他滨化疗的疗效及预后的关系进行分析。结果 外周血RRM1 的表达水平与性别、组织学类型及分期差异均无统计学意义（P >0.05）。低表达组的外周血RRM1 化疗有效率（35%）及疾病控制率（60%）均高于高表达组（10%，20%）（P <0.05）。生存分析显示：低表达组的外周血RRM1 生存期（14.8 个月）及无疾病进展期（4.4个月）均长于高表达组（11.6 个月，3.2 个月）（P <0.05）；低表达组的1 年生存率（76.7%）及2 年生存率（9.3%）均高于高表达组（53.3%，0%）（P <0.05）。结论 老年晚期非小细胞肺癌外周血中RRM1 低表达的患者对吉西他滨化疗反应率更高，生存期更长，是独立的预后因素。这为无法获取组织进行化疗药物筛选的老年晚期NSCLC 患者提供了一种新的选择。

RRM1 expression in peripheral blood and efficacy and prognosis of Gemcitabine in aged advanced NSCLC

Objective To investigate the clinical efficacy and prognostic significance of ribonucleotide reductase M1 (RRM1) expression in peripheral blood of aged patients with advanced non-small cell lung cancer (NSCLC) treated with Gemcitabine. Methods Blood samples were collected from 40 aged patients with advanced NSCLC to investigate the expression level of RRM1 in peripheral blood by real-time quantitative polymerase chain reaction (qRT-PCR). Relationships of the RRM1 expression with clinical characters, efficacy, overall survival time of the patients with aged advanced NSCLC were analyzed. Results There was no correlation between RRM1 expression in peripheral blood and gender, pathological type or TNM stage (P > 0.05). The patients with low expression of RRM1 had higher response rate (35%) and disease control rate (60%) to Gemcitabine than the patients with overexpression of RRM1 (10% and 20%, P < 0.05). The RRM1 low-expression group had longer overall survival time (14.8 m vs. 11.6 m), longer progression-free survival time (4.4 m vs. 3.2 m) and higher 1-year survival rate (76.7%vs. 53.3%) and 2-year survival rate (9.3% vs. 0.0%) than the RRM1 over-expression group (P < 0.05). Conclusions The aged patients with low levels of RRM1 expression in peripheral blood have higher response to chemotherapy and longer survival time. RRM1 expression in peripheral blood is an independet prognostic factor. This study may provide a new option for aged patients with advanced NSCLC who are unable to gain lung tissue for screening of chemotherapeutic drugs.