非小细胞肺癌患者外周血 AEG -1 mRNA 的表达及临床意义

目的：探讨非小细胞肺癌患者外周血AEG-1mRNA的表达情况及其临床意义。方法：收集104例新诊断的非小细胞肺癌患者外周血标本,RT—PCR法检测AEG-1mRNA表达水平,分析其与临床病理特征之间的关系。对其中52例接受含铂方案化疗的晚期患者随访12个月,探讨外周血AEG-1mRNA表达水平与化疗反应率及无进展生存期之间的关系。结果：非小细胞肺癌患者外周血高表达AEG-1mRNA,其表达水平与肿瘤分期（P=0．015）、组织分化程度（P=0．048）和远处转移（P=0．007）密切相关。接受含铂方案一线化疗的52例晚期患者中,AEG-1mRNA高表达者较低表达者对含铂方案化疗反应率低（25．0％VS58．3％,P=0．015）,中位无进展生存期短（5．25VS8．25个月,P=0．019）。结论：非小细胞肺癌外周血AEG-1mRNA高表达提示肿瘤分期晚、组织分化差、转移率高。外周血AEG-1mRNA表达有可能成为晚期非小细胞肺癌患者含铂方案-线化疗的疗效预测和预后因子。     

Keap1在非小细胞肺癌中的表达及与化疗疗效相关性的研究

背景与目的 已有研究表明Kelch样环氧氯丙烷相关蛋白1(Kelch-like ECH-associated protein1,Keap1)与铂类耐药相关.本研究旨在探讨Keap1在进展期非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达及其与一线含铂化疗方案疗效的相关性.方法 应用免疫组化检测50例进展期NSCLC患者组织标本中Keap1的表达.结果 进展期NSCLC患者中Keap1高表达率为26.0％; Keap1表达水平与化疗疗效、无进展生存期(progression free survival,PFS)有关(P＜0.05),而与性别、年龄、吸烟、病理类型、分化程度、转移和总生存期无关(P＞0.05).Keap1高表达组的中位PFS明显高于低表达组(P=0.002).多因素分析表明Keap1表达水平是一线化疗方案PFS的独立预测因素( P=0.007).结论 Keap1与进展期NSCLC一线化疗疗效和PFS有关,Keap1可能成为新的化疗疗效预测指标.     

ERCC1和BRCA1与非小细胞肺癌完全切除术后铂类化疗及预后的临床研究

目的:探讨ERCC1和BRCA1在ⅢA-N2期非小细胞肺癌(NSCLC)中的表达及其与铂类药物辅助化疗的相关性,为NSCLC个体化辅助化疗提供依据.方法:免疫组化方法检测ERCC1、BRCA1在89例手术完全切除并行含铂辅助化疗的ⅢA-N2期NSCLC中的表达.应用统计学软件SPSS 16.0行数据处理,回顾性分析ERCC1和BRCA1的表达与临床、病理各因素及患者预后的关系.结果:ⅢA-N2期NSCLC中ERCC1和BRCA1阳性表达率分别为46.1%和59.6%.ERCC1和BRCA1的表达与铂类化疗明显相关,表达阴性者在含铂化疗组有更长的无瘤生存期(P=0.000,P=0.022)和总生存期(P=0.000,P=0.009).ERCC1和BRCA1表达均阴性者在含铂化疗组有更长的无瘤生存期(P=0.000)和总生存期(P=0.000).结论:ERCC1表达阳性、组织病理分化低、全肺切除是影响ⅢA-N2期NSCLC预后的危险因子.ERCC1和BRCA1的表达与铂类化疗相关,表达均阴性者预后较好.     

BIM联合Scribble预测晚期非小细胞肺癌化疗效果

背景与目的：BIM基因和Scribble均是参与细胞凋亡的重要介质。BIM基因的BH3域缺失,可引起凋亡受阻。Scribble低表达对肿瘤细胞增殖、肿瘤转移和耐药有促进作用。通过检测BIM基因多态性和Scribble表达,探讨其与晚期非小细胞肺癌（non-small cell lung cancer,NSCLC）化疗效果的关系。方法：收集2014年1月—2015年12月于复旦大学附属中山医院就诊的96例晚期NSCLC患者,所有患者均一线接受含铂方案化疗。采用聚合酶链反应（polymerase chain reaction,PCR）检测NSCLC患者组织标本中的BIM基因多态性,采用免疫组织化学法检测标本中的Scribble表达水平,然后评估BIM基因多态性和Scribble表达与化疗疗效的关系。结果：BIM基因野生型组化疗的中位无进展生存期（progression-free survival,PFS）优于BIM基因缺失组（5.0个月 vs 2.7个月,P=0.01）。Scribble高表达组化疗的中位PFS优于Scribble低表达组（7.0个月 vs 4.0个月,P<0.001）。BIM基因野生型且Scribble高表达组（BIM-WT-Scrib-H）化疗的中位PFS优于BIM基因野生型或Scribble高表达组（BIM-WT/Scrib-H）和BIM基因缺失型且Scribble低表达组（BIM-del-Scrib-L）（10.0个月 vs 4.5个月 vs 2.0个月,P<0.001）。多因素分析结果显示,BIM基因缺失型为化疗具有更短PFS的独立预测因素（HR=3.221,P<0.001）;Scribble低表达为化疗具有更短PFS的独立预测因素（HR=3.312,P<0.001）。结论：BIM基因缺失型和Scribble低表达是晚期NSCLC化疗效果不佳的独立预测因素,两者联合应用有更好的预测价值。     

肺癌组织中ERCC-1表达对化疗疗效的预测价值

目的分析晚期非小细胞肺癌(non-smallcelllungcancer,NSCLC)石蜡包埋组织中错配切除修复蛋白(excisionrepaircrosscomplement-1,ERCC-1)与顺铂化疗敏感性的关系,并观察这些指标与患者生存的关系。方法收集广西医科大学附属肿瘤医院2000年2月1日~2004年6月30日经病理组织学诊断的晚期NSCLC患者(包括术后复发或不能手术)的病理标本,采用免疫组化SupervisionTM方法检测ERCC-1的表达,并将患者的疗效和生存资料与上述指标的表达进行比较。结果在51例病理组织中ERCC-1阳性33例,阳性率为64.7%(33/51)。ERCC-1阳性组化疗有效率为42.4%(14/33),阴性组有效率为72.2%(11/18),两者比较差异有统计学意义,χ2=4.151,P=0.042。ERCC-1阳性组平均生存期为9.3个月,阴性组为12.5个月,两组比较差异有统计学意义,χ2=5.61,P=0.018。ERCC-1阳性组1年生存率为30.3%(10/33),阴性组为72.2%(13/18),两组比较差异有统计学意义,χ2=8.267,P=0.004。结论ERCC-1对化疗疗效及生存的预测为负相关,可以作为晚期NSCLC含铂方案化疗敏感性及生存预测的指标。     

非小细胞肺癌中ERCC1的表达与新辅助化疗疗效之间的关系

背景与目的已有研究表明:肿瘤组织中核苷酸切除修复交叉互补组1(ERCC1)的阳性表达与铂类耐药密切相关,本研究探讨ERCC1在NSCLC中的表达及其与新辅助化疗疗效之间的关系。方法采用免疫组化法检测手术切除的73例NSCLC患者肿瘤组织中ERCC1的表达水平,其中33例接受含铂方案的新辅助化疗。采用χ2检验、Logrank分析和COX风险模型等分析ERCC1在NSCLC中的表达及其对新辅助化疗疗效的影响。结果ERCC1在NSCLC中的阳性表达率为34.25%。ERCC1的阳性率在新辅助化疗组(48.48%,16/33)要高于对照组(20.45%,9/40)(χ2=6.008,P=0.025)。ERCC1阳性组新辅助化疗客观缓解率31.3%,阴性组为58.8%(χ2=2.528,P=0.112);MST分别为36月和54月(P=0.118);3年生存率分别为43.8%和47.1%(χ2=0.029,P=0.866);5年生存率分别为18.8%和23.5%(χ2=0.414,P=0.520)。COX多因素回归分析结果显示:肿瘤组织中ERCC1表达水平、TNM分期和新辅助化疗与否是影响患者的预后因素。结论新辅助化疗可诱导NSCLC表达ERCC1,ERCC1高表达患者新辅助化疗客观缓解率低,ERCC1是影响该组患者预后的独立因素。     

切除修复交叉互补基因1表达与非小细胞肺癌患者吉西他滨联合顺铂化疗疗效的相关性

目的探讨非小细胞肺癌(NSCLC)患者肿瘤组织内核苷酸切除修复交叉互补基因1(ERCC1)表达与吉西他滨联合顺铂(GP方案)化疗疗效的相关性。方法采用免疫组化S-P法检测51例Ⅱb～Ⅳ期NSCLC患者肿瘤组织内ERCC1的表达。所有患者接受至少2个周期以上的GP方案化疗,对患者化疗后的中位生存期(MST)及化疗后反应率(RR)进行评估。结果 51例患者ERCC1的阳性表达率为43.14%(22/51)。ERCC1表达阳性组化疗后的RR和MST分别为50.0%、17个月,与阴性组RR(31.04%)、MST(12个月)比较,差异无统计学意义(χ2=1.8877,P=0.1695;χ2=1.6767,P=0.1954)。结论 ERCC1表达阳性的NSCLC患者能从吉西他滨联合顺铂的化疗中受益,调控ERCC1表达逆转耐药的策略,将为肿瘤治疗带来新的方法和途径。     

泰索帝联合铂类用于不同年龄晚期非小细胞肺癌的分析

目的比较不同年龄的晚期非小细胞肺癌(NSCLC)患者接受泰索帝与铂类联合化疗时,在生存期、住院天数、住院费用及毒副反应上的差异。方法对上海市胸科医院46例在2002年4月~2004年12月接受泰索帝与铂类联合化疗的晚期NSCLC患者进行回顾分析,根据年龄分为<70岁与≥70岁二组,用χ2检验对二组患者进行比较。用Kaplan-Meier进行生存分析,并用Cox回归分析了解与预后有关的因素。结果二组患者在生存期(χ2=0.41,P=0.5227)、住院天数(χ2=0.634,P=0.480)、住院费用(χ2=0.657,P=0.699)、血液学(χ2=1.963,P=0.274)和胃肠道副反应(χ2=1.414,P=0.344)上无明显差异。Cox回归分析提示患者化疗前后KPS评分的变化可能是影响患者预后的因素(P=0.023)。结论一般情况较好的高龄(≥70岁)NSCLC患者可以耐受泰索帝与铂类联合化疗方案。     

长春瑞滨与紫杉醇联合铂类治疗老年晚期非小细胞肺癌临床对照研究

目的观察比较长春瑞滨与紫杉醇加顺铂及卡铂联合方案治疗老年晚期非小细胞肺癌(NSCLC)的临床疗效和毒副反应.方法 76例年龄≥70岁的老年晚期NSCLC患者分别应用NP(长春瑞滨 顺铂)、NC(长春瑞滨 卡铂)及TC(紫杉醇 卡铂)方案化疗.每例患者至少完成2周期后评价疗效及毒副反应.3组患者一般特征具有可比性(P＞0.05).结果 3组患者有效率分别为NP组32.4%、NC组33.3%、TC组37.5%,3组间有效率比较差异无显著性(χ2=0.177,P＞0.05).NP组中位生存期10个月,1年生存率38.7%;NC组中位生存期10.25个月,1年生存率41.7%;TC组中位生存期12.5个月,1年生存率57.7%,3组间比较差异有显著性(χ2=12.66,P=0.0018).3组主要毒副反应为骨髓抑制及消化道反应,NP、NC、TC组Ⅲ～Ⅳ度白细胞减少发生率分别为46.4%、33.3%和58.3%(χ2=4.180,P＞0.05);NP组Ⅲ～Ⅳ度消化道反应较NC组及TC组明显,分别为14.3%、8.3%和4.2%(χ2=0.831,P＞0.05).3组病例均无化疗相关死亡发生.结论 NP、NC、TC联合方案是治疗老年晚期NSCLC有效且耐受性较好的方案.     

150例老年晚期非小细胞肺癌不同治疗方案回顾性分析

背景与目的 老年晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)无标准治疗,本研究比较含铂双药联合化疗、多西他赛单药及最佳支持治疗三种方法治疗老年晚期NSCLC的疗效、毒副作用及中位生存时间,探索老年晚期NSCLC最佳治疗方法.方法 回顾性分析2003年3月-2007年3月我院接受含铂双药联合化疗、多西他赛单药化疗及最佳支持.冶疗(best support care,BSC)三种不同治疗方案的150例老年NSCLC患者.结果 含铂双药联合化疗有效率明显较多西他赛单药化疗高.分别为41.2%和20.0%(P＜0.05).含铂舣药化疗、多西他赛单药化疗和最佳支持治疗组中位生存期分别为10.7个月、9.2个月和6.3个月,tO生存率分别为39.7%.36.7%和17.3%.化疗组中位生存时间较最佳支持治疗组明显延长(P＜0.05),1年生存率较最佳支持治疗组明显提高(P＜0.05).含铂双药化疗和多两他赛单药化疗中位生存期及1年生存率无统计学差异(P＞0.05);Ⅲ-Ⅳ度骨髓抑制及消化道毒副作用发生率含铂双药组较多西他赛单药组明显增高(P＜0.05).结论 与最佳支持治疗比,化疗能明显延长老年晚期NSCLC中位生存期.提高1年生存率.含铂双药化疗有效率虽较多西他赛单药化疗高,但毒副作用较大,中位生存期及1年生存率无统计学差异,单药化疗应成为老年晚期NSCLC的标准治疗.     

107例KRAS突变阳性非小细胞肺癌患者临床分析

背景与目的鼠类肉瘤病毒癌基因（Kirsten rat sarcoma viral oncogene,KRAS）是非小细胞肺癌（non-small cell lung cancer, NSCLC）的重要驱动基因之一,研究显示KARS是表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitors, EGFR-TKIs）药物的耐药标志,但其对于化疗敏感性及预后方面的意义存在争议。本研究旨在积累KRAS突变阳性的NSCLC患者治疗经验。方法我们回顾性分析了107例KRAS突变阳性的NSCLC患者的临床资料,分析KRAS突变阳性的NSCLC患者一线化疗疗效以及靶向治疗疗效。结果52例接受一线化疗的晚期KARS突变阳性NSCLC患者客观缓解率（objective response rate, ORR）为9.6%,疾病控制率（disease control rate, DCR）为53.8%,中位疾病无进展生存期（progression-free survival, PFS）为3个月;21例接受EGFR-TKIs药物治疗的KRAS突变阳性NSCLC患者ORR为9.5%,DCR为23.8%,PFS为1个月,其中EGFR/KRAS共突变患者接受EGFR-TKIs治疗的ORR及DCR均要显著高于单纯KRAS突变人群（50%vs 0,P=0.029;75%vs11.8%, P=0.043）,EGFR/KARS共突变患者接受EGFR-TKIs治疗的PFS较单纯KARS突变患者延长,可见统计学差异（3个月vs 1个月,P=0.004）。结论KRAS突变阳性NSCLC患者化疗有效率低,缓解时间短,EGFR-TKIs治疗效果差,亟需研发新的药物;EGFR/KARS共突变现象客观存在,EGFR-TKIs药物可作为这类患者有效的治疗选择之一。     

Increased expression levels of cyclin-dependent kinase inhibitor p27 correlate with good responses to platinum-based chemotherapy in non-small cell lung cancer

In order to determine whether expression of the cyclin-dependent kinase inhibitor p27 in non-small cell lung cancer (NSCLC) correlates with chemotherapeutic response, resected tumors from 22 patients with recurrent lung cancer who had undergone complete resection and received chemotherapy after the initial tumor recurrence were subjected to p27 immunostaining. Histological examination of the resected tumors revealed 14 adenocarcinomas, 7 squamous cell carcinomas and one adenosquamous cell carcinoma. Fifty percent or less and over 50% of the cells in the resected tumors of 11 patients each (groups 1 and 2, respectively) were p27-immunopositive. All but one patient received platinum-based chemotherapy after recurrence. Only one in group 1 achieved a partial response (PR) in chemotherapy whereas 2 and 4 in group 2 achieved complete and PRs, respectively. The chemotherapy response rate of group 2 (54%) was significantly higher than that of group 1 (9%, p=0.022). The times to recurrence after tumor resection of the 2 groups did not differ significantly (log-rank p=0.23, Wilcoxon p=0. 32), but survival after chemotherapy of group 2 was significantly better than that of group 1 (log-rank p=0.045, Wilcoxon p=0.028). It is suggested that high p27 expression levels in tumors may predict the good responses to platinum-based chemotherapy for NSCLC.     

Increased expression levels of p53 correlate with good response to cisplatin-based chemotherapy in non-small cell lung cancer

In order to determine whether expression of the tumor suppressor gene p53 in non-small cell lung cancer (NSCLC) correlates with chemotherapeutic response, resected tumors from 18 patients with recurrent lung cancer who had undergone complete resection and received chemotherapy after the initial tumor recurrence were subjected to p53 immunostaining. Histological examination of the resected tumors revealed 11 adenocarcinomas, 6 squamous cell carcinomas and one adenosquamous cell carcinoma. Group 1 was 50% (n=9) p53-immunopositive. All patients received cisplatin-based chemotherapy after recurrence. No patient in group 1 achieved response to chemotherapy whereas 2 and 3 in group 2 achieved complete and partial responses, respectively. The chemotherapy response rate of group 2 (56%) was significantly higher than that of group 1 (0%, p=0.009). The times to reoccurrence after tumor resection of group 2 was significantly better than that of group 1 (log-rank p=0.019, Wilcoxon p=0.042), and survival after chemotherapy of group 2 was also significantly better than that of group 1 (log-rank p=0.023, Wilcoxon p=0.034). It is suggested that high p53 expression levels in tumors correlate with both good response to cisplatin-based chemotherapy and good survival of patients with advanced NSCLC.     

乳腺癌耐药蛋白表达与晚期非小细胞肺癌铂类为主的化疗疗效及预后的关系

目的探讨乳腺癌耐药蛋白（BCRP）表达与晚期非小细胞肺癌（NSCLC）以铂类为主的化疗疗效及预后的关系。方法回顾性分析本院初治的B或期NSCLC患者86例,应用免疫组化方法检测每位患者肿瘤标本中的BCRP表达水平,应用SPSS 16.0进行统计分析,探讨BCRP表达水平与化疗疗效、无进展生存期（PFS）以及总生存期（OS）的关系。结果BCRP表达阴性患者的化疗有效率为44.0%,而表达阳性的患者为19.4%,两者之间差异有统计学意义（P=0.017）。BCRP表达阴性患者的PFS及OS较表达阳性的患者长,并且差异有统计学意义（P值分别为0.000和0.000）。多因素分析表明BCRP是独立影响PFS及OS的指标。结论BCRP表达水平与晚期NSCLC以铂类为主的化疗疗效及预后密切相关,对于进一步研究晚期NSCLC耐药机制,制定个体化治疗方案,延长患者生存期具有重要意义。     

ATP7A在非小细胞肺癌中的表达及其临床意义

  目的  探讨晚期非小细胞肺癌(NSCLC)组织中P型铜转运ATP酶(ATP7A)的表达与患者临床病理特征及预后的关系。  方法  采用免疫组织化学法检测89例未接受手术及放疗而只接受含顺铂方案一线化疗的晚期非小细胞肺癌组织中ATP7A的表达情况, 并分析ATP7A表达与患者临床病理特征及预后的关系。  结果  ATP7A的免疫阳性反应主要定位于非小细胞肺癌细胞的细胞质, ATP7A的标本阳性率为41.6%(37/89), 而在间质及正常肺组织均未见表达; ATP7A表达状态与含顺铂方案的化疗反应及组织分化分级呈正相关(P=0.001, P=0.039), 而与年龄(P=0.469)、性别(P=0.442)、分期(P=0.436)、PS(P=0.361)、组织学分型(P=0.670)及CEA水平(P=0.661)无关; Kaplan-Meier法生存分析显示ATP7A阳性表达的患者总生存(OS)低于ATP7A阴性表达患者(P=0.021);单因素分析显示ATP7A、分期、PS、CEA水平和组织分化分级和OS呈正相关(P值=0.021、P=0.019、P=0.004、P=0.022、P=0.010);多因素分析显示ATP7A、分期、CEA水平和组织分化分级是接受含铂方案化疗的晚期非小细胞肺癌患者OS的独立预后因子(P=0.045、P=0.001、P=0.003、P=0.009)。  结论  ATP7A在大部分晚期非小细胞肺癌组织中均有表达, ATP7A表达水平与晚期非小细胞肺癌的组织分化分级、含铂方案化疗疗效及患者生存期密切相关, 提示ATP7A与非小细胞肺癌的发生发展有关,可以作为含铂方案化疗的疗效预测因子及生存期的预后因子。      

Breast cancer resistance protein impacts clinical outcome in platinum-based chemotherapy for advanced non-small cell lung cancer.

PURPOSE: The purpose of this study was to investigate the relationship between the level of expression of ATP-binding cassette (ABC) transporter proteins, and response to chemotherapy and prognosis in advanced non-small cell lung cancer (NSCLC). EXPERIMENTAL DESIGN: Expression of ABC transporter proteins, including P-glycoprotein, multidrug resistance protein (MRP) 1, MRP2, MRP3, and breast cancer resistance protein (BCRP), was examined immunohistochemically in 72 formalin-fixed tumor samples from untreated stage IIIB or IV NSCLC patients. All of the patients received platinum-based chemotherapy. Response to chemotherapy, progression-free survival (PFS), and overall survival were compared in relation to expression of each of the ABC transporter proteins and clinicopathological factors. RESULTS: Expression of P-glycoprotein, MRP1, and MRP3 was not significantly associated with response to chemotherapy or survival. MRP2 expression was associated with overall survival (P = 0.002) but not with response to chemotherapy and PFS. By contrast, the response rate to chemotherapy of patients with BCRP-negative tumors was 44%, as opposed to 24% in patients with BCRP-positive tumors. Response rate was lower in BCRP-positive tumors, although this difference was not statistically significant (P = 0.08). BCRP-positive patients had also shorter PFS (P = 0.0003) and overall survival (P = 0.004) than BCRP-negative patients. Multivariate analysis confirmed BCRP status as an independent variable related to PFS (P = 0.001). CONCLUSIONS: Positive immunostaining for BCRP appears to be a predictor of survival in patients with advanced NSCLC. These findings indicate that BCRP may serve as a molecular target for reducing drug resistance to chemotherapy in advanced NSCLC patients.     

晚期非小细胞肺癌中ERCC1蛋白表达与铂类化疗药物敏感性的关系

目的探讨晚期非小细胞肺癌（NSCLC）中核苷酸切除修复交叉互补基因（ERCC1）的表达及其与铂类化疗药物疗效的相关性。方法采用免疫组化S-P法,检测69例Ⅲ、Ⅳ期非小细胞肺癌中ERCC1蛋白表达。所有患者采用以铂类为基础的方案化疗。结果 69例晚期NSCLC组织中ERCC1蛋白表达阳性率为39.13%（27/69）,鳞癌为41.94%（13/31）,腺癌为36.84%（14/38）,ERCC1蛋白表达阳性率与肿瘤组织学类型无关（χ2=0.1859,P=0.6663）。鳞癌患者ERCC1蛋白表达阴性者化疗有效率为44.44%,ERCC1阳性者化疗有效率为7.69%,两者比较差异有统计学意义（P=0.0448）;腺癌患者ERCC1表达阴性者化疗有效率为33.33%,ERCC1表达阳性者化疗有效率为21.43%,两者比较差异无统计学意义（P=0.4882）。不论鳞癌还是腺癌患者,ERCC1表达对患者生存期均无明显影响（P均〉0.05）。结论 ERCC1蛋白表达与晚期NSCLC患者的化疗疗效密切相关,尤其是鳞癌患者。     

Role of ERCC1 variants in response to chemotherapy and clinical outcome of advanced non-small cell lung cancer

Excision repair cross-complementation group 1 (ERCC1) and xeroderma pigmentosum-F (XPF) in the nucleotide excision repair pathway have been effectively repairing DNA damage induced by chemotherapeutic agents. We conducted a cohort study to assess the associations of ERCC1 and XPF polymorphisms with response to platinum-based chemotherapy and clinical outcome of non-small-cell lung cancer (NSCLC). One hundred eighty-seven NSCLC cases treated with platinum-based chemotherapy were prospectively analyzed. The predictive value of four SNPs in ERCC1 and two SNPs in XPF in patient's response and survival related to platinum-based chemotherapy were analyzed using χ ² tests, Kaplan-Meier method, log-rank test, and Cox proportional hazards regression. The overall chemotherapy response rate for treatment was 51.18 %. One hundred eighty-seven patients were followed up, and the median survival time is 17.6 months (ranged from 1 to 50 months). A total of 106 patients (56.68 %) died from NSCLC during the follow-up period. Carriers of the rs3212986 AA and A allele had a borderline significantly lower response rate to the chemotherapy. In the Cox proportional hazards model, patients carrying the ERCC1 rs3212986 AA genotype were significantly associated with increased risk of death from NSCLC when compared with those with CC genotype as a reference variable. This study reported that variants in ERCC1 can be used as a prognostic maker to platinum-based chemotherapy in NSCLC patients.     

Excision-repair-cross-complement-1 protein as a prognostic factor in patients with advanced non-small cell lung cancer treated with platinum-based first-line chemotherapy

Excision-repair-cross-complement-1 (ERCC1) protein expression in tumor cells has been associated with resistance to platinum compounds, the backbone of treatment in NSCLC. In the current study the impact of the tumoral ERCC1 protein expression on the outcome of patients with advanced stage NSCLC treated with platinum-based chemotherapy, was investigated. Ninety-four patients with inoperable stage III–IV NSCLC, treated with platinum-based first-line chemotherapy, were retrospectively analyzed. Pretreatment tumor samples were analyzed for ERCC1 protein expression using immunohistochemistry. Response to treatment, time to tumor progression (TTP), and overall survival (OS) were correlated with patients’ clinicopathological characteristics and ERCC1 protein expression on tumor cells. ERCC1 protein low expression was detected in 39 (41.5%) patients and did not correlate with patients’ clinicopathological characteristics or response to chemotherapy. However, ERCC1 protein low expression showed a trend for better disease control rate (p = 0.059), longer TTP (5.3 vs. 3.2 months; p = 0.051) and significantly longer OS (18.7 vs. 9.7 months; p = 0.009). ERCC1 could have a role in refining prognosis and thus individualizing chemotherapy for advanced stage NSCLC.     

老年人晚期非小细胞肺癌化疗疗效及预后分析

目的探讨年龄≥65岁的晚期非小细胞肺癌（NSCLC）患者含铂方案化疗疗效及预后因素。方法回顾性分析70例年龄≥65岁的ⅢA～Ⅳ期NSCLC患者一线含铂方案化疗疗效及不良反应;Kaplan—Meier法分析生存情况,COX回归法进行多因素预后分析。结果全组中位化疗数为3个周期,共有53例患者可评价疗效,总有效率41．5％（22／53）,且疗效不受年龄影响（X^2=1．945,P=0．378）;中位无进展生存时间6．0个月,中位生存时间12．5个月;化疗相关血液毒性发生率高;多因素分析提示ECOG评分、远处器官转移数目、化疗周期数是影响预后的独立因素。结论老年晚期NSCLC患者一线含铂方案化疗具有较高疗效,但不良反应发生率高,化疗耐受性较差,合理选择患者是关键;ECOG评分差、多发远处器官转移患者难以从化疗中获益;而对于可耐受化疗患者,3—6周期化疗可明显改善预后。