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目的:探讨Ⅰ-ⅢA期非小细胞肺癌(NSCLC)KRAS基因突变与核苷酸切除修复交叉互补基因1(ERCC1)、胸苷酸合成酶(TYMS)mRNA表达水平的相关性及其与患者临床病理特征的关系。方法:收集空军总医院胸外科2010年06月至2014年10月符合入组条件的Ⅰ-ⅢA期NSCLC患者69例,肺癌组织标本均为手术中切取,KRAS基因突变应用x TAG-液相芯片法检测,ERCC1、TYMS mRNA表达水平应用分支DNA-液相芯片法检测。结果:在69例检测样本中,共有13例存在KRAS基因突变,突变率为18.8%(13/69);男性患者中KRAS基因突变率(29.3%,12/41)较女性患者(3.6%,1/28)高(P=0.007)。ERCC1 mRNA的表达水平与病理类型、吸烟史、有无淋巴结转移、临床TNM分期相关(P<0.05),TYMS mRNA表达水平与患者各临床病理特征无关(P>0.05)。KRAS突变型患者ERCC1 mRNA表达水平比KRAS野生型患者高(P<0.05),KRAS基因突变与TYMS mRNA表达水平无关(P>0.05)。结论:在Ⅰ-ⅢA期NSCLC患者中,男性患者更容易发生KRAS突变。KRAS突变型患者可能不能从铂类化疗药物中受益,有利于指导早中期NSCLC患者术后的个体化治疗。
OBJECTIVE: To investigate the correlation between KRAS gene mutation and nucleotide excision and repair of the expression of ERCC1 and TYMS mRNA in patients with stage Ⅰ-ⅢA non-small cell lung cancer (NSCLC) Pathological characteristics of the relationship. Methods: Sixty-nine patients with stageⅠ-ⅢA NSCLC who were eligible for admission were collected from June 2010 to October 2014 in the Department of Thoracic Surgery, Air Force General Hospital. The lung cancer specimens were obtained during operation. KRAS gene mutations were detected by x TAG-LC Assay, the expression of ERCC1, TYMS mRNA was detected by branched DNA-liquid phase microarray. RESULTS: Of the 69 samples tested, KRAS gene mutation was found in 13 cases (18.8%, 13/69). The mutation rate of KRAS gene in male patients (29.3%, 12/41) was higher than that in female patients (3.6% 1/28) high (P = 0.007). The expression of ERCC1 mRNA was correlated with pathological type, smoking history, lymph node metastasis and TNM staging (P <0.05). The expression level of TYMS mRNA was not correlated with clinicopathological features (P> 0.05). The expression of ERCC1 mRNA in KRAS mutant group was higher than that in KRAS wild type group (P <0.05). The mutation of KRAS gene was not related to the expression of TYMS mRNA (P> 0.05). CONCLUSIONS: In patients with stage I-III A NSCLC, male patients are more likely to develop KRAS mutations. Patients with KRAS mutations may not benefit from platinum-based chemotherapeutics and are instructive in guiding individualized postoperative management of patients with early-stage NSCLC.