核苷酸切除修复交叉互补基因1在结直肠癌中的表达及其意义.DOCVIP

临床医学论文-核苷酸切除修复交叉互补基因1在结直肠癌中的表达及其意义 ??????????????? 作者：朱娟，肖菊香，张彦兵，王妍华，常浩，吴俊兰，张磊，王乐 【摘要】? 目的：探讨核苷酸切除修复交错互补基因1(ERCC1)在人结直肠癌中的表达水平，分析其与铂类药物化疗敏感性及生存时间的关系. 方法：以西安交通大学第一附属医院行结直肠癌根治术患者45例和剖腹探查术患者18例的标本为材料，采用免疫组织化学Elivision法检测其ERCC1表达水平. 其中40例复发、转移及晚期患者行草酸铂为基础方案化疗. 所有入组患者随访6年. 结果：肿瘤组织中ERCC1的阳性率为52.08％，低于对照组. 病理分级与ERCC1的阳性率之间有关（P=0.040），病理分级越高，ERCC1阳性率越低，表达强度越弱. ERCC1阴性者铂类药物化疗有效率为60.00%(12/20)，而阳性者则为25.00%(5/20)，二者之间具有统计学差异（P=0.025）；Cox回归分析显示ERCC1表达为结直肠癌患者独立预后因子（P=0.048）. 结论： ERCC1表达可作为预测结直肠癌患者对铂类药物敏感性及预后判断的指标之一. 【关键词】? 结直肠肿瘤; 核苷酸切除修复交叉互补基因1; 免疫组织化学; 耐药; 草酸铂 　　【Abstract】? AIM: To explore the excision repair crosscomplementing1 (ERCC1) expression level in human colorectal carcinoma, and analyze its relationship with the sensitivity of the platinum drugs and its prognosis. METHODS: Sixtythree archived samples of the patients with colorectal carcinoma were detected by immunohistochemical staining (Elivision). Fortyfive patients underwent radical surgical treatment and 18 patients exploratory laparotomy. All patients were followed up for 6 years after the operation. Forty advanced cases with recurrence and metastasis received oxaliplatinbased chemotherapy. RESULTS: In these 63 patients, the positive expression rate of ERCC1was 52.08％, significantly lower than that in the control group. The positivity rate was correlated with colorectal cancer histologic grade (P=0.040). The histologic grade higher, the positive rate of ERCC1 lower, the expression intensity weaker. In using oxaliplatin cases, the response rate of the ERCC1 negative group was 60.00% (12/20), that of the ERCC1 positive group was 25.00% (5/20). There was significant correlation between the expression of ERCC1 and the efficacy of chemotherapy (P=0.025）. The ERCC1 was an independent prognostic factor of colorectal cancer by the COX regression analysis (P=0.048). CONCLUSION: ERCC1 expression might be one of the prediction markers of the drug sensitivity of the platinum drugs and of prognosis in colorectal cance