晚期非小细胞肺癌组织ERCC1和BRCA1表达与铂类化疗敏感性临床研究

发布时间：2019-03-18 10:00

【摘要】：目的吉西他滨联合顺铂是治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的一线化疗方案,但其有效率仅20%~40%,其较低的化疗有效率与肿瘤耐药相关。研究NSCLC组织中切除修复交叉互补基因1(exeision repair cross-compietionl1,ERCC1)和乳腺癌易感基因1(breast cancer susceptibility gene-1,BRCA1)mRNA的表达及其与铂类化疗敏感性的关系。方法应用实时荧光定量PCR技术检测2009-03-01-2011-04-16武汉钢铁(集团)公司第二职工医院收集的98例晚期NSCLC患者中ERCC1和BRCA1mRNA的表达情况,分析其与含铂联合治疗方案化疗耐药性的关系。结果检测98例患者中ERCC1和BRCA1mRNA的相对表达量,其中位数分别为0.048和0.011,四分位间距IQR分别为0.0058和0.001。ERCC1mRNA的高表达率为56.1%(55/98),其表达在不同性别、年龄、组织学类型及临床分期中差异无统计学意义,P0.05;BRCA1mRNA的高表达率为64.3%(63/98),其表达在不同性别、年龄、组织学类型及临床分期中差异无统计学意义,P0.05。在ERCC1mRNA低表达组GP方案化疗客观缓解率为48.8%(21/43),而在高表达组化疗客观缓解率为29.1%(16/55),两组之间比较差异有统计学意义,χ~2=4.0,P=0.045;在BRCA1mRNA低表达组GP化疗客观缓解率为57.1%(20/35),在高表达组GP化疗客观缓解率为28.6%(18/63),差异有统计学意义,χ~2=7.74,P=0.005;ERCC1和BRCA1 mRNA联合低表达组中GP化疗客观缓解率为70.4%(19/27),而其联合高表达组GP化疗客观缓解率仅为21.1%(8/38)。结论 ERCC1、BRCA1mRNA高表达患者在使用含铂化疗方案时疗效差,提示ERCC1和BRCA1 mRNA高表达NSCLC患者对铂类具有耐药性。ERCC1和BRCA1mRNA联合低表达患者在使用含铂方案化疗时有效率更高,提示应用ERCC1和BRCA1mRNA联合检测时,患者可获得更大的益处。
[Abstract]:Aim gemcitabine combined with cisplatin is a first-line chemotherapy regimen for advanced non-small cell lung cancer (non-small cell lung cancer,NSCLC), but its effective rate is only 20% to 40%. The lower response rate of gemcitabine combined with cisplatin is related to drug resistance. To investigate the expression of excision repair cross complementary gene (1 (exeision repair cross-compietionl1,ERCC1) and breast cancer susceptible gene (1 (breast cancer susceptibility gene-1,BRCA1) mRNA in NSCLC tissues and their relationship with platinum chemosensitivity. Methods Real-time fluorescence quantitative PCR was used to detect the expression of ERCC1 and BRCA1mRNA in 98 patients with advanced NSCLC collected from Wuhan Iron and Steel (Group) Company's second worker's Hospital in 2009 / 03 / 01 / 2011 / 04 / 16. The relationship between chemotherapy resistance and platinum-containing chemotherapy regimen was analyzed. Results the relative expression of ERCC1 and BRCA1mRNA was detected in 98 patients, the median was 0.048 and 0.011, the quartile distance IQR was 0.0058 and the high expression rate of 0.001.ERCC1mRNA was 56.1% (55 / 98). There was no significant difference in age, histological type and clinical stage, P 0.05; The high expression rate of BRCA1mRNA was 64.3% (63 / 98), and there was no significant difference among sex, age, histological type and clinical stage (P 0.05). The objective response rate of GP regimen was 48.8% (21 / 43) in the low expression group of ERCC1mRNA, and 29.1% (16 / 55) in the high expression group. There was significant difference between the two groups (蠂 ~ 2 ~ 4. 0, P < 0. 045). The objective response rate of GP chemotherapy was 57.1% (20 / 35) in the low expression group of BRCA1mRNA and 28.6% (18 / 63) in the high expression group of GP. The difference was statistically significant (蠂 ~ 2 = 7.74, P < 0.05). In the low expression group of ERCC1 and BRCA1 mRNA, the objective response rate of GP chemotherapy was 70.4% (19 / 27), while that of the high expression group of GP chemotherapy was only 21.1% (8 / 38). Conclusion patients with high expression of ERCC1,BRCA1mRNA have poor curative effect when using platinum-containing chemotherapy regimen, suggesting that NSCLC patients with high expression of ERCC1 and BRCA1mRNA are resistant to platinum, and the patients with low expression of ERCC-1 and BRCA1mRNA are more effective in chemotherapy with platinum-containing regimen than those with high expression of ERCC-1 and BRCA1mRNA. It is suggested that the patients can gain more benefit when ERCC1 and BRCA1mRNA are used together.
【作者单位】：武汉钢铁(集团)公司第二职工医院检验科;武汉钢铁(集团)公司第二职工医院肿瘤科;武汉钢铁(集团)公司第二职工医院外科;
【基金】：武汉市临床医学科研项目(WX14C28)
【分类号】：R734.2

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