论文部分内容阅读
目的本研究通过回顾性分析,从针对非小细胞肺癌(NSCLC)一线化疗的铂类、吉西他滨、微管类药物中,选择各自具有代表性的耐药基因ERCC1、RRM1、class Ⅲβ-tubulin进行联合检测,了解中国NSCLC患者上述基因表达水平以及联合表达的分子亚型分布规律,为制定适合中国国情的NSCLC个体化治疗提供临床依据。方法收集解放军第307医院1994年6月至2007年8月间初治行手术治疗的NSCLC患者共105例。采用免疫组化的方法检测手术标本中ERCC1、RRM1、class Ⅲβ-tubulin蛋白表达,分析ERCC1、RRM1、classⅢβ-tubulin蛋白在NSCLC患者中的表达水平、共表达规律以及与患者临床特征、总生存期的关系。结果 105例NSCLC癌组织中ERCC1表达阳性率为43.8%(46/105),RRM1阳性表达率达83.8%(88/105);class Ⅲβ-tubulin蛋白阳性表达率达83.8%(88/105)。ERCC1、RRM1、class Ⅲβ-tubulin蛋白表达与患者年龄、性别、吸烟史、组织学类型、细胞分化程度、TNM分期及淋巴结转移无关。ERCC1、RRM1、class Ⅲβ-tubulin蛋白共表达规律可见:ERCC1(-)、RRM1(+)、class Ⅲβ-tubulin(+)表达患者共41例,占39.05%;ERCC1(+),RRM1(+),class Ⅲβ-tubulin(+)表达患者共37例,占35.19%,两者所占比例最高。生存分析显示:ERCC1(-)、RRM1(+)、class Ⅲβ-tubulin(+)表达患者,辅助化疗组较单纯手术组MST有延长趋势(P=0.198),而ERCC1(+),RRM1(+),class Ⅲβ-tubulin(+)与之相反(P=0.193)。结论 NSCLC患者耐药基因的高表达不容忽视,尤其共表达规律显示ERCC1(+),RRM1(+),class Ⅲβ-tubulin(+)基因型的患者可能不能从辅助化疗中获益,因此开展NSCLC患者个体化治疗势在必行。
OBJECTIVE: In this retrospective analysis, ERCC1, RRM1, and class Ⅲβ-tubulin were selected from platinum, gemcitabine and microtubule drugs targeting first-line chemotherapy of non-small cell lung cancer (NSCLC) Detection, understanding of Chinese patients with NSCLC gene expression levels and the combined expression of molecular subtypes, to provide a clinical basis for the development of individualized treatment for NSCLC suitable for China’s national conditions. Methods A total of 105 patients with NSCLC who underwent surgical treatment at the 307 Hospital of PLA from June 1994 to August 2007 were enrolled. The expressions of ERCC1, RRM1 and class Ⅲβ-tubulin in surgical specimens were detected by immunohistochemistry. The expressions of ERCC1, RRM1 and classⅢβ-tubulin in patients with NSCLC were analyzed. The expression of ERCC1, Relationship. Results The positive rate of ERCC1 expression in 105 cases of NSCLC was 43.8% (46/105), the positive rate of RRM1 was 83.8% (88/105). The positive rate of class Ⅲβ-tubulin was 83.8% (88/105). The expressions of ERCC1, RRM1 and class Ⅲβ-tubulin were not associated with age, sex, smoking history, histological type, cell differentiation, TNM stage and lymph node metastasis. The co-expression of ERCC1, RRM1 and class Ⅲβ-tubulin showed that there were 41 cases (39.05%) of ERCC1 (+), RRM1 (+ , class Ⅲβ-tubulin (+) expression in patients with a total of 37 cases, accounting for 35.19%, the highest proportion of both. Survival analysis showed that patients with ERCC1 (-), RRM1 (+), and class Ⅲβ-tubulin (+) expressed more prolonged MST in the adjuvant chemotherapy group than in the surgery group (P = 0.198) ), while class Ⅲβ-tubulin (+) was the opposite (P = 0.193). Conclusion The high expression of drug resistance genes in patients with NSCLC can not be ignored. In particular, the expression of ERCC1 (+), RRM1 (+) and class Ⅲβ-tubulin (+) genotypes may not benefit from adjuvant chemotherapy. Individual patient treatment is imperative.