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目的探讨RRM1、ERCC1蛋白表达与晚期(IIIB～IV)非小细胞肺癌(NSCLC)吉西他滨联合顺铂(GP)方案化疗疗效及预后的关系。方法回顾性分析47例曾接受GP方案化疗的晚期NSCLC患者的临床病理资料,采用免疫组织化学法检测病理标本中RRM1、ERCC1蛋白表达,对化疗疗效及生存时间进行分析。结果 RRM1、ERCC1蛋白阳性率分别为46.81%(22/47)、42.55%(20/47),其表达与性别、年龄、PS评分、组织学类型、分期、吸烟均无相关性,化疗有效率为36.17%(17/47),RRM1、ERCC1蛋白阳性及阴性患者化疗有效率分别为18.18%(4/22)和52.00%(13/25),20.00%(4/20)和48.15%(13/27),差异有统计学意义(P=0.016、0.047)。RRM1、ERCC1蛋白低表达者中位生存期皆为14.1个月,RRM1、ERCC1蛋白高表达者中位生存期分别为6.8、7.1个月(P=0.008、0.017);RRM1、ERCC1蛋白均阴性表达者的预后明显好于1个或2个阳性表达者,中位生存期分别为14.8、7.6个月(P=0.012)。COX回归分析显示,分期是晚期NSCLC的独立预后影响因素。结论 RRM1、ERCC1表达水平与NSCLC患者GP方案的化疗近期疗效及预后为负相关关系,RRM1、ERCC1低表达的晚期NSCLC患者更能从GP方案中获益。
Objective To investigate the relationship between the expression of RRM1 and ERCC1 and the efficacy and prognosis of advanced (IIIB-IV) non-small cell lung cancer (NSCLC) gemcitabine combined with cisplatin (GP) regimen. Methods The clinical and pathological data of 47 patients with advanced NSCLC who received GP regimen were retrospectively analyzed. The expression of RRM1 and ERCC1 protein in pathological specimens was detected by immunohistochemistry, and the efficacy and survival time of chemotherapy were analyzed. Results The positive rates of RRM1 and ERCC1 protein were 46.81% (22/47) and 42.55% (20/47), respectively. There was no correlation between the expression of RRM1 and ERCC1 protein in gender, age, PS score, histological type, (36.17%, 17/47). The effective rates of chemotherapy for RRM1 and ERCC1 protein positive and negative patients were 18.18% (4/22) and 52.00% (13/25), 20.00% (4/20) and 48.15% / 27), the difference was statistically significant (P = 0.016,0.047). The median survival time of both RRM1 and ERCC1 protein low expression was 14.1 months, and the median survival time of RRM1 and ERCC1 protein high expression were 6.8 and 7.1 months (P = 0.008 and 0.017 respectively). Both RRM1 and ERCC1 protein were negative The prognosis was significantly better than one or two of the positive expression, the median survival were 14.8,7.6 months (P = 0.012). COX regression analysis showed that staging is an independent prognostic factor for advanced NSCLC. Conclusions The expression of RRM1 and ERCC1 is negatively correlated with the recent efficacy and prognosis of chemotherapy in patients with NSCLC. The patients with advanced NSCLC with low expression of RRM1 and ERCC1 are more likely to benefit from the GP regimen.