CAJ | 학술논문

目的：观察非小细胞肺癌（NSCLC）肿瘤组织中切除修复交叉互补组l（ERCC1）的基因和蛋白表达变化，并探讨其意义。方法212例NSCLC患者，根治性手术且术后辅助铂类化疗，采用实时荧光定量逆转录聚合酶链反应（ RT-PCR）和免疫组化法分别检测手术切除肿瘤组织中ERCC1 mRNA和蛋白的表达，并分析其和患者预后生存的关系。结果212例患者中79例（37．26％）患者ERCC1 mRNA低表达，133例（62．74％）高表达；70例（33．02％）患者ERCC1蛋白低表达，142例（66．98％）高表达。 ERCC1 mRNA表达水平与临床分期（P＜0．0001）、病理类型（P＝0．005）、分化程度（P＝0．028）、淋巴转移（P＜0．0001）有关；ERCC1蛋白表达水平与临床分期（P＝0．015）、病理类型（P＝0．016）、淋巴结转移（P＝0．018）有关。 NSCLC患者ERCC1 mRNA低表达者的中位无疾病生存时间（DFS）明显长于高表达者（25．9νs 19．4个月，P＜0．0001）。但NSCLC患者的ERCC1蛋白低表达者的中位DFS与高表达者比较无明显差异（21．5νs 21．0个月，P＝0．282）。多因素回归分析结果显示只有临床分期是影响患者DFS的独立预后因素。 ERCC1 mRNA水平与ERCC1蛋白表达之间呈负相关（r＝-0．230，P＝0．001）。结论行手术切除且术后行铂类辅助化疗的NSCLC患者中，ERCC1 mRNA低表达者比高表达者的DFS延长，且可以从铂类化疗中获益，ERCC1 mRNA的表达水平比ERCC1蛋白表达水平更适合作为以铂类为基础化疗NSCLC患者预后和预测指标。
목적：관찰비소세포폐암（NSCLC）종류조직중절제수복교차호보조l（ERCC1）적기인화단백표체변화，병탐토기의의。방법212례NSCLC환자，근치성수술차술후보조박류화료，채용실시형광정량역전록취합매련반응（ RT-PCR）화면역조화법분별검측수술절제종류조직중ERCC1 mRNA화단백적표체，병분석기화환자예후생존적관계。결과212례환자중79례（37．26％）환자ERCC1 mRNA저표체，133례（62．74％）고표체；70례（33．02％）환자ERCC1단백저표체，142례（66．98％）고표체。 ERCC1 mRNA표체수평여림상분기（P＜0．0001）、병리류형（P＝0．005）、분화정도（P＝0．028）、림파전이（P＜0．0001）유관；ERCC1단백표체수평여림상분기（P＝0．015）、병리류형（P＝0．016）、림파결전이（P＝0．018）유관。 NSCLC환자ERCC1 mRNA저표체자적중위무질병생존시간（DFS）명현장우고표체자（25．9νs 19．4개월，P＜0．0001）。단NSCLC환자적ERCC1단백저표체자적중위DFS여고표체자비교무명현차이（21．5νs 21．0개월，P＝0．282）。다인소회귀분석결과현시지유림상분기시영향환자DFS적독립예후인소。 ERCC1 mRNA수평여ERCC1단백표체지간정부상관（r＝-0．230，P＝0．001）。결론행수술절제차술후행박류보조화료적NSCLC환자중，ERCC1 mRNA저표체자비고표체자적DFS연장，차가이종박류화료중획익，ERCC1 mRNA적표체수평비ERCC1단백표체수평경괄합작위이박류위기출화료NSCLC환자예후화예측지표。
Objective To detect the mRNA and protein expression of ERCC 1 in human non-small cell lung carcinoma (NSCLC), and the correlation between them,and to investigate its relationship with prognosis following post-operative adju-vant platinum chemotherapy .Methods:The expression of ERCC 1 protein was examined by immunohistochemistry ( IHC) , and the expression of ERCC1 mRNA was examined by RT-PCR.we had analyzed 212 patients with NSCLC who underwent post-operative adjuvant platinum chemotherapy .The relationship of ERCC1 with disease-free survival ( DFS) and overall survival (OS) was analyzed.Results: ERCC1 with mRNA low expression patients disease free survival was significantly prolonged compared with High expression patients (median DFS 25.9 vs 15.4 months, P <0.0001).Multivariate Cox re-gression analysis showed that clinical TNM stage (HR=2.936, P=0.022) were significant independent predictors of DFS for patients with lung cancer , but There was no significant difference between the DFS of low ERCC 1 protein expression and high ERCC1 protein expression(median DFS 21.5 νs 21.0 months,P =0.282).Multivariate Cox regression analysis showed that clinical TNM stage(HR=2.726, P=0.033)were significant independent predictors of DFS for patients with lung cancer.the expression of ERCC1 mRNA was negatively related to the expression of ERCC 1 protein.Conclusion: the patients of stage Ⅰ-ⅢA with low expression of ERCC 1 had a longer disease-free survival than those with high expression of ERCCl.ERCC1 mRNA low expression was in relation with better prognosis following Adjuvant Cisplatin Chemotherapy in Operable NSCLC .The expression of ERCC1 mRNA was more suitable than the expression of ERCC 1 protein as a prognos-tic factor and predictive marker for platinum-based chemotherapy in operable NSCLC .