晚期非小细胞肺癌组织中ERCC1、RRM1表达水平与含铂治疗方案疗效及预后相关性分析

目的：探讨ERCC1及RRM1的表达在预测晚期非小细胞肺癌含铂治疗方案疗效及预后中的作用。方法：用免疫组织化学的方法检测124例ⅢB和Ⅳ期非小细胞肺癌患者的石蜡包埋活检组织标本中ERCC1和RRM1的表达水平，并分析其与临床病理特征以及疗效、预后的相关性。124例均为接受以铂类为基础的三代药物联合化疗的初治患者。结果：ERCC1、RRM1表达阳性者分别为43例（35％）和50例（40％）。ERCC1及RRM1的表达与疗效相关，ERCC1表达阴性者疗效达PR的患者（54％）明显高于阳性者（33％），差异有统计学意义（P=0．022）。同样，RRM1表达阴性患者疗效为PR的明显高于RRM1阳性者（53％VS34％，P=0．042）。ERCC1和RRM1同时阴性表达者的中位生存时问明显长于同时阳性表达者（11．7个月VS9．2个月，P=0．025），多因素分析表明，ERCC1为独立的预后预测因素（P=0．0066）。结论：ERCC1的表达与晚期非小细胞肺癌预后及含铂治疗方案疗效相关。

Expression of ERCCI, RRMI in Advanced Non - Small Cell Lung Cancer and Therapeutic Effect of Platinum -based Chemotherapy as well as Its Prognosis

Objective：To determine a role of ERCC1 and RRM1 expression in predicting response and survival in Chinese patients with advanced stage non -small cell lung cancer（NSCLC） treated with platinum - based chemotherapy. Methods： Formalin - fixed, paraffin - embedded biopsy tissues were retrospectively obtained from 124 advanced（ stage HI b and IV ） NSCLC patients treated with platinumbased chemotherapy. Protein expression levels of ERCC1 and RRM1 were determined by immunobistochemistry（IHC）. Associations between expression of ERCC1 and RRM1 and clinic- pathologic parameters were analyzed. Results：The study showed that ERCC1 and RRM1 expression was detected in 43（35% ） and 50（40% ） of the 124 tumor samples respectively. Expression of ERCC1 and RRM1 was associated with tumor response. Fifty - four percent patients whose tumors did not express ERCC1 had partial response（PR） compared with 33% whose tumors expressed the protein（P =0.022）. Similarly, 53% patients whose tumor did not express RRM1 had PR compared with 34% whose tumors expression the protein（P = 0.042）. Further, patients whose tumors lacked ERCC1 but not RRM1 expression had a longer median survival time than those tumors expressed ERCC1 （11.7 months vs 9.2 months ; P = 0. 025 ） , which was independent of other prognostic factors （ P = 0. 0066 ）. Conclusions ： Tumor ERCC1 expression is associated with tumor response and patients＇ survival in Chinese advanced NSCLC pa- tients treated with platinum - based regimen and may serve as a biomarker in predicting tumor response and clinical outcome in the patient population.