CAJ | 학술논문

目的:探讨DNA切除修复基因ERCC1在晚期非小细胞肺癌(non-small cell lung callcer,NSCLC)中的表达与非铂类及铂类化疗方案敏感性的关系.方法:青海大学附属肿瘤医院2006年2月1日～2008年6月30日经病理组织学诊断的Ⅲb-Ⅳ期NSCLC患者130例,采用免疫组化法检测130例患者肿瘤组织中错配切除修复蛋白(exci-sion repair coross complementl(ERCC1)表达水平,并将其分组治疗:A组:ERCC1阴性患者,选用第三代新药含铂类方案;B组:ERCC1阳性患者,选用第三代新药非铂类方案;C组:ERCC1阳性患者选用第三代新药含铂类方案.结果:在130例病理组织中ERCC1阳性率为47.8%(62/130),ERCC1鳞癌中为35.7%(25/70),在腺癌中表达为62.4%(25/40),在腺癌和鳞癌中的表达差异有统计学意义,X~2=7.366,P=0.007.A组、B组和C组化疗有效率分别为58.8%(40/68)、51.6%(16/31)及32.3%(10/31),A、C组间差异有统计学意义,X~2=6.011,P=0.014.B、C组比较化疗疗效提高,但差异无统计学意义,X~2=2.384,P=1.123;A、B组差异无统计学意义,X~2=0.451,P=0.502.A组中住生存期为12.0个月,B组为11.0个月,C组为7.8个月,A、B组间差异无统计学意义,X~2=3.809,P>0.051;A、C组间差异有统计学意义,X~2=46.368,P<0.001;C、B组间差异有统计学意义,X~2=21.251,P<0.001.结论:ERCC1阴性表达患者选用第三代新药加铂类两药方案有较好化疗疗效及可延长生存,ERCC1阳性表达患者选用第三代新药非铂类两药方案可提,高化疗疗效及生存;ERCC1表达可以作为晚期NSCLC含铂方案化疗敏感性预测的指标,根据分子预测指标对制定个性化治疗计划的可行性.
목적:탐토DNA절제수복기인ERCC1재만기비소세포폐암(non-small cell lung callcer,NSCLC)중적표체여비박류급박류화료방안민감성적관계.방법:청해대학부속종류의원2006년2월1일～2008년6월30일경병리조직학진단적Ⅲb-Ⅳ기NSCLC환자130례,채용면역조화법검측130례환자종류조직중착배절제수복단백(exci-sion repair coross complementl(ERCC1)표체수평,병장기분조치료:A조:ERCC1음성환자,선용제삼대신약함박류방안;B조:ERCC1양성환자,선용제삼대신약비박류방안;C조:ERCC1양성환자선용제삼대신약함박류방안.결과:재130례병리조직중ERCC1양성솔위47.8%(62/130),ERCC1린암중위35.7%(25/70),재선암중표체위62.4%(25/40),재선암화린암중적표체차이유통계학의의,X~2=7.366,P=0.007.A조、B조화C조화료유효솔분별위58.8%(40/68)、51.6%(16/31)급32.3%(10/31),A、C조간차이유통계학의의,X~2=6.011,P=0.014.B、C조비교화료료효제고,단차이무통계학의의,X~2=2.384,P=1.123;A、B조차이무통계학의의,X~2=0.451,P=0.502.A조중주생존기위12.0개월,B조위11.0개월,C조위7.8개월,A、B조간차이무통계학의의,X~2=3.809,P>0.051;A、C조간차이유통계학의의,X~2=46.368,P<0.001;C、B조간차이유통계학의의,X~2=21.251,P<0.001.결론:ERCC1음성표체환자선용제삼대신약가박류량약방안유교호화료료효급가연장생존,ERCC1양성표체환자선용제삼대신약비박류량약방안가제,고화료료효급생존;ERCC1표체가이작위만기NSCLC함박방안화료민감성예측적지표,근거분자예측지표대제정개성화치료계화적가행성.
Objective: To determine the predictive value of excision repair cross complement 1 (ERCC1) expression in non-small cell lung cancer (NSCLC) and the sensitivity of NSCLC to non-cisplatin based chemo-therapy and cisplatin based chemotherapy. Methods: The expression of ERCC1 was examined by immunohis-tochemical technique in 130 patients with advanced NSCLC seen in our hospital between February 1st 2006 and October 30th 2007. These 130 patients were divied into three groups. Patients in group A (n=68) had neg-ative ERCC1 expression and received cisplatin based chemotherapy. Patients in group B (n=31) had positive expression of ERCC1 and received non-cisplatin based chemotherapy. Patients in group C (n=31) had posi-tive expression of ERCC1 and received cisplatin based chemotherapy. Results: The expression rate of ER-CC1 was 62 of 130 (47.8%). The rate of ERCC1 in pulmonary adenocarcinoma was higher than that in squa-mous carcinoma. The response rates of chemotherapy in group A, B, and C group were 58.8 %, 51.6%, and 41.5%, respecitvely. There was no significant difference in the response rate between group A and group B (X~2=0.451, P=0.502). There was a significant difference in the response rate between group A and group C (X~2= 6.011, P=0.014). The response rate in group B was higher than that in group C (X~2=2.384, P=1.123). The average survival time in group A, group B, and group C were 12.0 months, 11.0 months, and 7.8 months, respecit-vely. There was no significant difference in patient survival between group A and group B (X~2=3.809, P=0.051). There was significant difference in patient survival between group A and group C (X~2=46.368, P=0.000). Con-clusion: ERCC1 may be an important indicator of the sensitivity of advanced NSCLC to cisplatin or non-cisplat-in based chemotherapy.