晚期结肠癌组织中ERCC1和BRCA1的表达与奥沙利铂方案化疗疗效及预后的关系

目的 探讨晚期结肠癌组织中切除修复交叉互补基因1(excision repair cross-complementinggene l，ERCCl)和乳腺癌易感基因l(breast cancer susceptibility gene l，BRCAl)的表达情况及其与临床病理特征、奥沙利铂方案化疗疗效及预后之间的关系。方法 采用免疫组织化学方法检测晚期结肠癌组织中ERCCl和BRCAl蛋白的表达状况。结果 晚期结肠癌组织中ERCCl和BRCA1蛋白表达阳性率分别为41.2%和47.4%。ERCCl和BRCA1蛋白的表达与患者的年龄、性别、肿瘤分化程度和肿瘤部位均无关（P>0.05），结肠癌组织中ERCC1蛋白表达与BRCA1蛋白表达呈正相关（r=0.211，P=0.038）。ERCCl和BRCA1蛋白表达阴性患者奥沙利铂方案化疗有效率高于表达阳性患者（P＜0.05）。ERCCl蛋白表达阴性患者化疗后，中位生存期(median survival time，MST)高于表达阳性患者(P=0.014)；BRCAl蛋白表达阴性患者化疗后MST高于表达阳性患者，但差异无统计学意义(P=0.201)。Cox回归模型分析结果显示ERCC1蛋白的表达状态和肿瘤分化程度是影响结肠癌预后的独立因素。结论 晚期结肠癌中ERCCl和BRCAl蛋白的表达存在相关性，ERCCl和BRCAl的表达对奥沙利铂方案化疗疗效具有预测价值，并且ERCC1的表达状态可作为预后判断依据，而BRCA1在晚期肠癌预后判断中的价值则有待进一步研究。

Correlation of ERCCl,BRCAl Expression and Chemotherapeutic Effect and Prognosis#br# of Oxaliplatin Regimens in Advanced Colon Cancer Tissues

Objective To investigate the correlation of ERCCl, BRCAl proteins expression andclinicopathological features, chemotherapeutic effect and prognosis of Oxaliplatin regimens in advancedcolon cancer tissues. Methods Immunohistochemistry was used to measure ERCCl and BRCAl proteinsexpression in advanced colon cancer tissues. Results The positive rate of ERCCl and BRCAl proteinsexpression were 41.2% and 47.4% respectively. ERCCl and BRCAl proteins expression were not associatedwith gender, age, differentiation degree or the position of tumor(P＞0.05). The positive expression of ERCClprotein had a significantly positive correlation with that of BRCA1 protein in advanced colon cancer(r=0.211,P=0.038). The response rate of chemotherapy in patients with ERCCl and BRCAl negative expression wassignificantly higher than that with positive expression(P＜0.05). Compared with ERCCl positive patients,ERCCl negative patients had longer median survival time(MST) with statistical difference(P=0.014).Compared with BRCAl positive patients, BRCAl negative patients had longer MST without statisticaldifference(P=0.201). COX multivariate analysis showed that ERCC1 protein expression and differentiationdegree were independently factors correlated with the prognosis of advanced colon cancer patients.Conclusion The expression of ERCCl and BRCA1 had a significant correlation. ERCC1 is a predictivemarker for chemotherapeutic effect and prognosis of platinum-based regiment, however, BRCA1 is only apredictive factor for chemotherapeutic effect on advanced colon cancer patients and its value in the prognosisstill needs more investigation.