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目的探讨胃癌术后患者核苷酸切除修复交叉互补基因1(ERCC1)、胸苷酸合成酶(TS)表达与术后辅助化疗预后的关系。方法选取86例初次诊断为胃癌行胃癌根治术、术后病理诊断为Ⅱ~Ⅲ期的患者,术后均采用XELOX辅助化疗方案化疗,并进行4年以上随访。运用免疫组化方法检测患者癌组织中ERCC1、TS蛋白表达情况,分析ERCC1、TS表达与术后辅助化疗预后的关系。结果 86例胃癌患者癌组织中ERCC1和TS的阳性表达率分别为40%和36%。ERCC1和TS阳性表达率与肿瘤的分化程度相关。ERCC1阴性表达者和TS阴性表达者平均生存期均明显长于阳性表达者(P均<0.05)。多因素COX回归分析表明,ERCC1、TS阳性表达者术后辅助化疗预后差[HR=0.29,95%CI(0.12,0.69),P=0.006;HR=0.49,95%CI(0.20,0.87),P=0.010]。结论 ERCC1与TS表达情况可以作为预测胃癌术后辅助化疗预后的分子标志物。
Objective To investigate the relationship between the expression of ERCC1 and thymidylate synthase (TS) and postoperative adjuvant chemotherapy in postoperative gastric cancer patients. Methods Eighty-six patients with primary gastric cancer who underwent radical gastrectomy and postoperative pathological diagnosis of stage II-III were enrolled. All patients received XELOX-assisted chemotherapy and received more than 4 years of follow-up. Immunohistochemistry was used to detect the expression of ERCC1 and TS protein in cancer tissues, and the relationship between the expression of ERCC1 and TS and prognosis of adjuvant chemotherapy was analyzed. Results The positive expression rates of ERCC1 and TS in the cancer tissue of 86 patients with gastric cancer were 40% and 36%, respectively. The positive rate of ERCC1 and TS is related to the degree of tumor differentiation. The average survival time of ERCC1 negative expression and TS negative expression was significantly longer than that of positive expression (P<0.05). Multivariate COX regression analysis showed that the prognosis of adjuvant chemotherapy after ERCC1 and TS positive expression was poor [HR=0.29, 95%CI (0.12, 0.69), P=0.006; HR=0.49, 95% CI (0.20, 0.87), P=0.010]. Conclusion The expression of ERCC1 and TS can be used as a molecular marker to predict the prognosis of postoperative adjuvant chemotherapy for gastric cancer.