食管鳞癌基因多态性表达与生存分析

目的:探讨食管鳞癌肿瘤组织中ERCC1、TYMS、TUBB3基因表达与预后生存的关系。方法:选择2012年9月至2016年5月我科收治的68例食管鳞癌患者，术后病理分期IIa-IIIa期；检测肿瘤组织ERCC1、TYMS、TUBB3 mRNA表达水平。术后患者分为个体化化疗组和标准化疗组，个体化组患者根据基因检测结果选择敏感药物化疗方案（CF/DCF/TC方案）进行化疗，标准组应用CF方案化疗，所有患者长期随访，统计化疗不良反应及生存数据。结果:肿瘤组织中ERCC1、TYMS、TUBB3阳性表达率分别为43%、47%、51%，无统计学差异（P＞0.05）。所有患者总一年生存率、两年生存率及三年生存率为分别为90.57%，72.45%和59.77%。生存曲线分析提示:0项基因阳性组预后最佳（P＜0.05），而1项、2项和3项基因阳性组间无统计学差异（P＞0.05）。个体化化疗组的III/IV级化疗不良反应发生率明显低于标准化疗组（P＜0.05）。结论:食管鳞癌患者中ERCC1、TYMS、TUBB3表达具有特定的临床特征，其高表达患者预后欠佳。根据基因检测结果进行个体化化疗可以获得更好的疗效和耐受性，不良反应更轻。

Expression of gene polymorphisms and survival analysis in patients with esophageal squamous cell carcinoma

Objective:To explore the expression characteristics of ERCC1,TYMS and TUBB3 and survival analysis of esophageal squamous cell carcinoma.Methods:Sixty-eight patients with esophageal squamous cell carcinoma admitted to our department from September 2012 to May 2016 were selected.They accepted radical resection of esophageal carcinoma and pathological stage was IIa-IIIa after operation.The mRNA expression levels of ERCC1,TYMS and TUBB3 in tumor tissues were detected.Postoperative patients were divided into individualized chemotherapy group and standard chemotherapy group.Patients of individualized chemotherapy group choosesensitive regimen(CF or TC)according to gene expression.Standard chemotherapy group received CF regimen.All patients were followed up for a long time.The adverse events of chemotherapyand survivaldata were recorded.Results:The positive expression rates of ERCC1,TYMS and TUBB3 in tumor tissues were 43%,47%and 51%respectively,with no statistically differences(P>0.05).The one-year survival rate of patients was 90.57%,two-year survival rate was 72.45%,and three-year survival rate was 59.77%,respectively.The survival curve analysis among the groups showed that the prognosis of 0-positive gene expression group was the best of four groups(P<0.05),while there was no statistical difference in the 1,2 and 3-positivegeneexpression groups(P>0.05).The incidence of grade III/IV adverse eventsin individualized chemotherapy group was significant lower than that in the standard chemotherapy group(P<0.05).Conclusion:Expressions of ERCC1,TYMS and TUBB3 in patients with esophageal squamous carcinoma have specific clinical characteristics.The prognosis of patients with high expression of ERCC1 is poor.Postoperative adjuvant chemotherapy based on the detection results can achieve better efficacy and tolerancs.