CAJ | 학술논문

目的探讨切除修复交叉互补基因1( excision repair cross complement 1,ERCC1)的表达对进展期胃癌辅助化疗及预后的影响.方法进展期胃癌患者共88例,分为新辅助组45例,手术组43例.新辅助组行2个疗程XELOX方案新辅助化疗,再行标准胃癌根治术,术后再行4个疗程的XELOX方案化疗；手术组行标准胃癌根治术,术后行6个疗程的XELOX方案化疗.对2组均随访3年,观察疗效及3年无复发生存率.结果新辅助组和手术组患者ERCC1阳性表达率分别为49％和44％.新辅助组45例患者化疗有效率为49％,ERCC1阴性表达患者对化疗敏感(P＜0.05).ERCC1阴性表达患者3年无复发生存率为64％,显著高于阳性表达患者的30％,两者相比差异有统计学意义,P＜0.05；手术组ERCC1阴性表达患者3年无复发生存率为79％,显著高于阳性表达患者的38％,两者相比差异有统计学意义,P＜0.05.COX回归模型分析结果显示ERCC1表达与3年无病生存率密切相关,P ＜0.05.结论 ERCC1的表达与进展期胃癌患者的化疗敏感性及预后有关,可用于其预后及化疗敏感性的预测.
목적 탐토절제수복교차호보기인1( excision repair cross complement 1,ERCC1)적표체대진전기위암보조화료급예후적영향.방법 진전기위암환자공88례,분위신보조조45례,수술조43례.신보조조행2개료정XELOX방안신보조화료,재행표준위암근치술,술후재행4개료정적XELOX방안화료；수술조행표준위암근치술,술후행6개료정적XELOX방안화료.대2조균수방3년,관찰료효급3년무복발생존솔.결과 신보조조화수술조환자ERCC1양성표체솔분별위49％화44％.신보조조45례환자화료유효솔위49％,ERCC1음성표체환자대화료민감(P＜0.05).ERCC1음성표체환자3년무복발생존솔위64％,현저고우양성표체환자적30％,량자상비차이유통계학의의,P＜0.05；수술조ERCC1음성표체환자3년무복발생존솔위79％,현저고우양성표체환자적38％,량자상비차이유통계학의의,P＜0.05.COX회귀모형분석결과현시ERCC1표체여3년무병생존솔밀절상관,P ＜0.05.결론 ERCC1적표체여진전기위암환자적화료민감성급예후유관,가용우기예후급화료민감성적예측.
Objective To investigate the effect of expression of excision repair cross complementing 1(ERCC1) on adjuvant chemotherapy and prognnsis in advanced gastric cancer.Methods In this study 88 advanced gastric cancer cases were divided into initial neoadjuvant chemotherapy group (45 patients) and upfront surgical group (43 cases).In neoadjuvant chemotherapy group two courses neoadjuvant chemotherapy with XELOX were given before an interval standard radical gastrectomy.Postoperatively another four cycles of chemotherapy with XELOX were given; In upfront surgical group standard radical gastrectomy was done followed by 6 cycles of postoperative chemotherapy with XELOX;Patients in the two groups were followed up for 3 years.Results ERCC1positive expression were 49％ and 44％ in neoadjuvant group and surgical patients; Response rate in neoadjuvant chemotherapy group was 49％.Patients with ERCClnegative expression were more sensitive to chemotherapy (P ＜0.05 ); 3-year recurrence-free survival rate in patients with ERCC1negative expression was 64％,which was significantly higher than 30％ in patients with positive expression,the difference was statistically significant (P ＜ 0.05 ) ;3-year recurrence-free survival rate in initial surgical group patients with ERCCl-negative expression was 79％,significantly higher than in patients with positive expression (38％),the difference was statistically significant (P ＜0.05) ; Cox regression analysis revealed that ERCC1expression is closely related to 3-year disease-free survival ( P ＜ 0.05 ). Conclusions ERCC1expression in patients with advanced gastric cancer is related to chemosensitivity and prognosis,it can forecast the prognosis and chemotherapy sensitivity.