ERCC1表达对结肠癌患者术后辅助化疗疗效及预后的影响

目的：探讨结肠癌术后患者核苷酸切除修复交叉互补基因1（ exsicion repair cross-complementing group 1，ERCC1）的表达对术后辅助化疗疗效及预后的影响。方法：选取初次诊断为结肠癌并行结肠癌根治术且术后分期为Ⅱ、Ⅲ期的患者60例，所有患者术后均采用FOLFOX6（ L-OHP＋5-Fu＋CF）方案辅助化疗，并进行3年随访。运用免疫组织化学方法检测患者癌组织中ERCCl蛋白。结果：60例结肠癌患者组织中ERCC1的阳性表达率为41.67％，低分化腺癌患者中ERCC1阳性表达率较高分化患者低，差异有统计学意义（ P＜0.05）。 Kaplan-Meier生存曲线显示：ERCC1阴性表达者3年DFS优于阳性表达者，差异有统计学意义（ P＜0.05）。多因素Cox回归模型分析表明，ERCC1是结肠癌患者DFS的影响因素（ RR＝3.45，95％CI：1.47-7.54，P＝0.012）。其中在同一ERCC1表达水平下，分化程度越高的患者，预后越好（ RR＝0.41，95％CI：0.22-0.75，P＝0.023）。结论：ERCC1表达水平可以作为预测结肠癌Ⅱ、Ⅲ期患者术后辅助化疗无病生存时间的预测指标。 ERCC1阴性表达的患者无病生存时间延长，可以从奥沙利铂为主的FOLFOX方案中受益。

Effects of ERCC1 expression on efficacy and prognosis of postoperative adjuvant chemotherapy in patients with colon cancer

Objective：To investigate the effects of nucleotide excision repair cross-complementing group 1 （ ERCC1） expression on the efficacy and prognosis of postoperative adjuvant chemotherapy in patients with colon cancer.Methods： Sixty patients who were diagnosed with colon cancer for the first time, treated by radical operation for colon cancer, and then divided into postoperative pathological stage Ⅱ or Ⅲ were included in our study. All the patients, received FOLFOX6 （ L-OHP＋5-Fu＋CF） protocol for adjuvant chemotherapy and were followed up for 3 years. Immunohistochemistry was used to detect the expression level of ERCC1 protein in the colon cancer tissues. Results：The positive expression rate of ERCC1 in 60 cases of colon cancer tissues was 41. 67%. And patients with low-differentiated adenocarcinoma had higher positive expression rate than patients with high-differentiated adenocarcinoma were low in high differentiation, the difference was statistically significant （ P〈0.05） . Kaplan-Meier survival curve showed that the 3 years DFC in patients with negative ERCC1 expression was better than that in patients with positive ERCC1 expression,the difference was statistically significant （ P〈0. 05） . Multi-factor Cox regression model analysis showed that ERCC1 was the influencing factor of disease-free survival （DFS） in patients with colon cancer （RR=3.45, 95%CI：1.47-7.54, P=0.012）. While, under the same ERCC1 expression level, patients with higher differentiation degree hadbetter prognosis （ RR=0.41, 95%CI：0.22-0.75, P=0.023）.Conclusion：The expression level of ERCC1 can be used as an index to predict DFS of postoperative adjuvant chemotherapy in patients with stage II and III colon cancer. And the extended DFS in patients with ERCC1 negative expression can benefit from the oxaliplatin-based FOLFOX protocol.