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目的研究探讨Ⅲ、Ⅳ期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者癌组织内核苷酸切除修复交叉互补组1基因(ERCC1)、乳腺癌易感染基因1(BRCA1)、核苷酸还原酶M1(RRM1)表达与铂类标准化疗方案化疗疗效的关系。方法共入选Ⅲ、Ⅳ期NSCLC患者80例,所有患者都接受至少2周期的化疗,以GP、NP、TP方案为主。ERCC1、BRCA1及RRM1表达水平的检测采用免疫组化二步法。对患者化疗后的疗效与ERCC1、BRCA1、RRM1表达水平的关系进行评价。结果 80例患者中,ERCC1阳性患者与阴性患者有效率分别为28.8%、71.4%,BRCA1阳性患者与阴性患者化疗有效率分别为30.0%、57.5%,RRM1阳性患者与阴性患者化疗有效率分别为30.2%、70.4%,阳性患者与阴性患者有效率比较,差异均有统计学意义(P均<0.05)。ERCC1、BRCA1、RRM1均阴性表达者化疗有效率明显高于阳性表达者(66.1%vs31.8%,P均<0.05)。结论 ERCC1、BRCA1、RRM1表达不同可能是化疗方案中铂类药物敏感性差别的重要因素,可能为临床NSCLC患者个体化用药提供可参考的依据。
Objective To investigate the relationship between nucleotide excision and repair 1 (ERCC1) gene, breast cancer susceptibility gene 1 (BRCA1) and nucleoside in patients with stage Ⅲ and Ⅳ non-small cell lung cancer (NSCLC) The Relationship between the Expression of Acid Reductase M1 (RRM1) and the Chemotherapy of Platinum Standard Chemotherapy. Methods A total of 80 patients with stage Ⅲ and Ⅳ NSCLC were enrolled in this study. All patients underwent chemotherapy for at least 2 cycles with GP, NP and TP regimens. The expression of ERCC1, BRCA1 and RRM1 were detected by immunohistochemical two-step method. The efficacy of chemotherapy after chemotherapy and ERCC1, BRCA1, RRM1 expression levels were evaluated. Results Among the 80 patients, the ERCC1 positive patients and negative patients were 28.8% and 71.4% respectively. The effective rates of chemotherapy in patients with positive and negative BRCA1 were 30.0% and 57.5%, respectively. The effective rates of chemotherapy in patients with positive and negative RRM1 were 30.2% and 70.4% respectively. There was significant difference between the positive and negative patients (P <0.05). The effective rate of chemotherapy in patients with negative expression of ERCC1, BRCA1 and RRM1 was significantly higher than that of positive expression (66.1% vs 31.8%, P <0.05). Conclusion The different expressions of ERCC1, BRCA1 and RRM1 may be important factors for the difference of sensitivity of platinum drugs in chemotherapy regimens, and may provide a reference for the individualized use of drugs in patients with NSCLC.