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目的:观察肿瘤组织核糖核酸调节亚单位1(RRM1)、乳腺癌易感基因1(BRCA1)表达与ⅢB/Ⅳ期肺鳞癌采用吉西他滨联合顺铂(GP)方案化疗疗效的相关性。方法:初治ⅢB/Ⅳ期肺鳞癌且体能状态(PS)评分0~2分、预计生存期≥3个月的患者入选本研究。入选患者均进行GP方案化疗,每3周为1个周期,每2个周期评价1次疗效,共4个周期,无效者更换二线化疗方案。免疫组化检测肿瘤组织中RRM1、BRCA1表达。根据RRM1、BRCA1表达高低分为A组(RRM1-/BRCA1-)、B组(RRM1+/BRCA1+)、C组(RRM1+/BRCA1-)、D组(RRM1-/BRCA1+)。评价疗效指标:客观反应率(RR)、总生存时间(OS)、肿瘤至进展时间(TTP)。结果 :①入组78例ⅢB/Ⅳ期肺鳞癌患者,RRM1、BRCA1表达阳性率分别为47.4%(37/78)、51.3%(40/78),RRM1、BRCA1不同表达的患者临床特征比较差异无统计学意义;②78例患者A组22例,B组21例,C组19例,D组16例。化疗前4组间的临床特征比较差异无统计学意义。4组患者RR分别为59.1%、38.1%、42.1%、43.8%;OS分别为(617.4±19.6)、(299.2±20.5)、(336.6±22.7)、(324.7±24.2)d;TTP分别为(274.9±21.8)、(138.8±18.0)、(172.3±17.3)、(167.3±19.8)d。其中A组的RR、OS及TTP均优于其他3组,差异有统计学意义(P值分别为0.039、0.000和0.000)。结论:RRM1、BRCA1可作为GP方案疗效的预测分子;RRM1、BRCA1低表达的肺鳞癌患者,可能是GP化疗方案的优势人群。
OBJECTIVE: To investigate the relationship between the expression of ribonucleic acid subunit 1 (RRM1) and the susceptibility gene for breast cancer 1 (BRCA1) in patients with stage ⅢB / Ⅳ squamous cell carcinoma of the lungs treated with gemcitabine combined with cisplatin (GP). Methods: The newly diagnosed stage ⅢB / Ⅳ squamous cell carcinoma was divided into two groups according to the score of physical status (PS) of 0 to 2, and the expected survival time of ≥3 months was enrolled in this study. Patients were enrolled in the GP regimen of chemotherapy, every 3 weeks for a cycle, evaluated once every 2 cycles, a total of 4 cycles, ineffective replacement of second-line chemotherapy. Immunohistochemical detection of tumor tissue RRM1, BRCA1 expression. According to RRM1, BRCA1 expression was divided into group A (RRM1- / BRCA1 -), group B (RRM1 + / BRCA1 +), group C (RRM1 + / BRCA1 -) and group D (RRM1- / BRCA1 +). Evaluation of efficacy indicators: objective response rate (RR), total survival time (OS), tumor to progress (TTP). Results: ①The positive rates of RRM1 and BRCA1 in 47 cases of stage ⅢB / Ⅳ squamous cell carcinoma were 47.4% (37/78) and 51.3% (40/78), respectively. The clinical features of patients with different expression of RRM1 and BRCA1 There was no significant difference between the two groups. ② In the 78 patients, there were 22 cases in group A, 21 cases in group B, 19 cases in group C and 16 cases in group D. There was no significant difference in the clinical features among the 4 groups before chemotherapy. The RRs of the patients in the four groups were 59.1%, 38.1%, 42.1% and 43.8%, respectively; the OS were (617.4 ± 19.6), (299.2 ± 20.5), (336.6 ± 22.7) and (324.7 ± 24.2) d, respectively 274.9 ± 21.8), (138.8 ± 18.0), (172.3 ± 17.3), (167.3 ± 19.8) d. The RR, OS and TTP of group A were better than the other three groups (P = 0.039, 0.000 and 0.000, respectively). Conclusions: RRM1 and BRCA1 can be used as predictors of the efficacy of GP regimen. Patients with lung squamous cell carcinoma with low expression of RRM1 and BRCA1 may be the predominant population of GP chemotherapy regimens.