CAJ | 학술논문

目的：探讨切除修复交叉互补基因1（ ERCC1）在鼻咽癌组织中的表达，并分析其表达与局部晚期鼻咽癌同步放化疗疗效的关系。方法收集2010年1月至2010年12月经鼻咽部肿物活检确诊均为非分化型非角化性鼻咽癌患者76例，给予顺铂单药同步放化疗。化疗方案具体为顺铂80mg／m2，静脉滴注，于放疗第1、22、43天进行；放疗采用常规分割照射，5次／周，鼻咽平均剂量74Gy（70～78Gy），同步放化疗结束后评价其近期疗效并随访远期生存情况。应用免疫组化法检测鼻咽癌组织中ERCC1蛋白表达，分析其表达与同步放化疗近期疗效及远期生存率的关系。结果76例鼻咽癌组织中ERCC1蛋白的阳性表达率为42?1％（32／76）。 ERCC1蛋白表达与鼻咽癌的T分期、临床分期有关（P＜0?05），而与性别、年龄及N分期无关（P＞0?05）。 ERCC1蛋白阳性表达者的有效率（RR）为75?0％（24／32），ERCC1阴性表达者的RR为97?7％（43／44），差异有统计学意义（ P＝0?008）。获得随访的72例患者的1年、2年、3年生存率分别为91?0％、83?3％、79?0％。 ERCC1阴性表达者的1年、2年、3年生存率分别为92?4％、87?8％、80?5％， ERCC1阳性表达者的1年、2年、3年生存率分别为87?9％、77?4％、77?4％，两者的中位生存期（ OS）差异无统计学意义（ P＞0?05）。ERCC1阳性表达者中不同分级的中位OS差异有统计学意义（ P＜0?05）。结论 ERCC1蛋白的表达可能是预测局部晚期鼻咽癌同步放化疗近期疗效及预后的指标。
목적：탐토절제수복교차호보기인1（ ERCC1）재비인암조직중적표체，병분석기표체여국부만기비인암동보방화료료효적관계。방법수집2010년1월지2010년12월경비인부종물활검학진균위비분화형비각화성비인암환자76례，급여순박단약동보방화료。화료방안구체위순박80mg／m2，정맥적주，우방료제1、22、43천진행；방료채용상규분할조사，5차／주，비인평균제량74Gy（70～78Gy），동보방화료결속후평개기근기료효병수방원기생존정황。응용면역조화법검측비인암조직중ERCC1단백표체，분석기표체여동보방화료근기료효급원기생존솔적관계。결과76례비인암조직중ERCC1단백적양성표체솔위42?1％（32／76）。 ERCC1단백표체여비인암적T분기、림상분기유관（P＜0?05），이여성별、년령급N분기무관（P＞0?05）。 ERCC1단백양성표체자적유효솔（RR）위75?0％（24／32），ERCC1음성표체자적RR위97?7％（43／44），차이유통계학의의（ P＝0?008）。획득수방적72례환자적1년、2년、3년생존솔분별위91?0％、83?3％、79?0％。 ERCC1음성표체자적1년、2년、3년생존솔분별위92?4％、87?8％、80?5％， ERCC1양성표체자적1년、2년、3년생존솔분별위87?9％、77?4％、77?4％，량자적중위생존기（ OS）차이무통계학의의（ P＞0?05）。ERCC1양성표체자중불동분급적중위OS차이유통계학의의（ P＜0?05）。결론 ERCC1단백적표체가능시예측국부만기비인암동보방화료근기료효급예후적지표。
Objective To investigate the expression of DNA excision repair cross-complementing gene 1( ERCC1) in local andvanced nasopharyngeal carcinoma, and to analyze the relationship between the expression of ERCC1 and the efficacy of concurrent radiochemotherapy in the treatment of nasopharyngeal carcinoma. Methods Seventy-six patients with none differentiated and the diver-sification nasopharyngeal carcinoma by nasopharyngeal neoplasm biopsy accepted single-agent cisplatin ( DDP 80mg/m2 , intravenous drip) concurrent chemoradiotherapy from January 2010 to December 2010. Radiation therapy was performed with the conventional seg-mentation illuminate 5/week on d1, d22, d43 with mean dose of 74Gy(70-78Gy) for nasopharyngeal. The curative effects were evaluated and the long-term survival was followed up. Immunohistochemistry was used to detect the ERCC1 protein expression in nasopharyngeal carcinoma tissue. The relationship between the expression of ERCC1 and the sensitivity of concurrent radiochemotherapy and long-term survival rate were analyzed. Results The positive rate of ERCC1 in 76 patients was 42?1%( 32/76) . The expression of ERCC1 was related to the T classification and clinical stage( P<0?05) , but not to gender, age and N staging. The response rates of the ERCC1 pos-itive and negative patients were 75?0% and 97?7% with statistical significance( P<0?05) . Of 72 follow-up cases, the 1-,2-and 3-year survival rates of all were 91?0%,83?3% and 79?0% and those for the ERCC1 negative and the positive patients were 92?4%, 87?8%, 80?5% and 87?9%, 77?4%, 77?4%, respectively. The overall survival( OS) of ERCC1 positive and negative patients had no statisti-cally significant difference( P>0?05) . The medium OS of ERCC1 positive patients among different classification had statistically signifi-cant difference( P<0?05) . Conclusion The ERCC1 expression may be a sensitive prognostic indicator of the concurrent radiochemo- therapy in local advanced nasopharyngeal carcinoma.