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目的探讨切除修复交叉互补基因(ERCC1)蛋白在Ⅲ期胃癌中表达及其与预后的关系。方法采用免疫组化En Vision二步法检测477例Ⅲ期胃癌组织中ERCC1蛋白的表达情况,并分析其与预后的关系。结果胃癌组织中ER-CC1蛋白阳性表达率为67.1%(320/477)。ERCC1阳性表达的320例患者中,化疗组中位生存期(MST)为30.9个月,5年生存率为30%;未化疗组MST为26.3个月,5年生存率为25%,差异无统计学意义(P=0.184)。ERCC1阴性表达的157例患者中,化疗组MST为33.0个月,5年生存率30%;未化疗组MST为18.5个月,5年生存率为9%,差异有统计学意义(P=0.000)。未行术后辅助化疗的131例患者中,ERCC1阳性表达者生存时间长于阴性者(P=0.034)。Cox多因素分析显示,肿块大小、浸润深度、有无脉管神经受侵、淋巴结转移、化疗与否为胃癌的独立预后因素。结论胃癌根治术后患者ERCC1阴性表达者可从含铂方案辅助化疗中获益;ERCC1阳性可能是预后良好的指标,但应用含铂药物化疗后患者似乎未能显著延长生存。
Objective To investigate the expression of excision repair cross-complementing gene (ERCC1) protein in stage III gastric cancer and its relationship with prognosis. Methods EnVision two-step immunohistochemistry was used to detect the expression of ERCC1 protein in 477 cases of stage III gastric cancer, and its relationship with prognosis was analyzed. Results The positive expression rate of ER-CC1 protein in gastric cancer was 67.1% (320/477). Among the 320 patients with positive ERCC1 expression, the median survival time (MST) in the chemotherapy group was 30.9 months, and the 5-year survival rate was 30%; the MST in the non-chemotherapy group was 26.3 months, and the 5-year survival rate was 25%. Statistical significance (P=0.184). Among the 157 patients with negative ERCC1 expression, the MST in the chemotherapy group was 33.0 months, and the 5-year survival rate was 30%; the MST in the non-chemotherapy group was 18.5 months, and the 5-year survival rate was 9%. The difference was statistically significant (P=0.000). ). Among the 131 patients who did not undergo postoperative adjuvant chemotherapy, the survival of ERCC1 positive patients was longer than that of negative patients (P=0.034). Cox multivariate analysis showed that tumor size, depth of invasion, presence of vascular nerve invasion, lymph node metastasis, and chemotherapy were independent prognostic factors of gastric cancer. Conclusions ERCC1 negative expression in patients with gastric cancer after radical resection can benefit from platinum-based adjuvant chemotherapy; ERCC1 positive may be a good indicator of prognosis, but patients with platinum-containing chemotherapy do not seem to significantly prolong survival.