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目的探讨ⅢB/IV期非小细胞肺癌(NSCLC)RRM1表达与吉西他滨化疗疗效间关系。方法回顾性分析61例接受以吉西他滨化疗的ⅢB/IV期NSCLC临床病理资料。免疫组织化学法检测肿瘤标本RRM1蛋白表达,并对化疗疗效及生存时间进行分析。结果RRM1阳性表达(≥50%阳性染色细胞)率为42.6%(26/61),与性别、年龄、组织类型及临床分期无关。化疗有效率(CR+PR)为34.4%(21/61),其中RRM1高表达患者化疗有效率和控制率分别为19.2%(5/26)和80.8%(21/26),而RRM1低表达患者分别为35.7%(16/35)和100%(35/35)(P=0.031、0.025)。RRM1高表达者有较短的中位OS(10个月)和PFS(6个月),而低表达患者有较长的中位OS(13个月)和PFS(10个月)(P=0.046、0.038)。COX回归分析表明RRM1是晚期NSCLC的独立预后影响因素。结论RRM1高表达NSCLC患者对吉西他滨药物耐药且预后不良。
Objective To investigate the relationship between the expression of RRM1 in stage ⅢB / IV non-small cell lung cancer (NSCLC) and the efficacy of gemcitabine chemotherapy. Methods The clinical data of 61 patients with stage ⅢB / IV NSCLC receiving gemcitabine chemotherapy were retrospectively analyzed. Immunohistochemistry was used to detect the expression of RRM1 protein in tumor samples. The effects of chemotherapy and survival time were analyzed. Results The positive rate of RRM1 expression (≥50% positive staining cells) was 42.6% (26/61), regardless of sex, age, type of tissue and clinical stage. The effective rate of chemotherapy (CR + PR) was 34.4% (21/61). The effective rate and control rate of chemotherapy in patients with high RRM1 expression were 19.2% (5/26) and 80.8% (21/26) Patients were 35.7% (16/35) and 100% (35/35), respectively (P = 0.031,0.025). Patients with high RRM1 expression had a shorter median OS (10 months) and PFS (6 months), while patients with low expression had a longer median OS (13 months) and PFS (10 months) (P = 0.046, 0.038). COX regression analysis showed that RRM1 is an independent prognostic factor for advanced NSCLC. Conclusions Patients with RRM1-overexpressing NSCLC are resistant to gemcitabine and have a poor prognosis.