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目的探讨核苷酸切除修复交错互补基因-1(ERCC1)和核糖核苷酸还原酶亚单位M1(RRM1)在非小细胞肺癌组织中的表达水平,分析其与吉西他滨/顺铂化疗敏感性及生存时间的关系。方法以71例ⅢB~Ⅳ期肺癌患者的穿刺或手术标本为材料,采用免疫组织化学方法检测其ERCC1和RRM1的表达水平。Cox回归分析筛选影响预后的独立危险因子,Kaplan-Meier生存曲线分析比较不同ERCC1和RRM1表达水平患者的中位生存期和无病进展时间。结果非小细胞肺癌组织中ERCC1的阳性率为46.5%,RRM1的阳性率为56.3%。ERCC1低表达者接受吉西他滨/顺铂的化疗效果优于高表达者,两者间的差异有统计学意义(P=0.036);RRM1低表达者接受吉西他滨/顺铂的化疗效果优于高表达者,两者间的差异具有统计学意义(P=0.003),ERCC1和RRM1低表达的患者生存期明显长于高表达者(P值分别为0.002和0.001)。结论 ERCC1和RRM1的表达可作为非小细胞肺癌患者吉西他滨/顺铂方案化疗敏感性及其预后判断的指标之一。
Objective To investigate the expression of ERCC1 and RRM1 in non-small cell lung cancer (NSCLC) and its relationship with the sensitivity of gemcitabine / cisplatin and its chemosensitivity The relationship between survival time. Methods Totally 71 cases of stage ⅢB-Ⅳ lung cancer patients were punctured or surgically resected. The expressions of ERCC1 and RRM1 were detected by immunohistochemistry. Cox regression analysis was used to screen independent risk factors influencing prognosis. Kaplan-Meier survival curve analysis was performed to compare the median survival and disease-free progression time in patients with different ERCC1 and RRM1 expression levels. Results The positive rate of ERCC1 in non-small cell lung cancer was 46.5% and the positive rate of RRM1 was 56.3%. Chemotherapy of gemcitabine / cisplatin was more effective in patients with low expression of ERCC1 than in those with high expression, the difference was statistically significant (P = 0.036); chemotherapy with gemcitabine / (P = 0.003). The survival of patients with low expression of ERCC1 and RRM1 was significantly longer than that of high expression (P = 0.002 and 0.001, respectively). Conclusion The expression of ERCC1 and RRM1 may be used as one of the indicators of chemosensitivity and prognosis in non-small cell lung cancer patients with gemcitabine / cisplatin regimen.