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目的比较非小细胞肺癌(non-small cell lung cancer,NSCLC)患者原发灶与转移淋巴结中切除修复交叉互补基因1(excision repair cross-complementation group1,ERCC1)和核糖核苷酸还原酶M1亚基(ribonucleotidereductase subunit M1,RRM1)表达情况,探讨ERCC1和RRM1表达状态与NSCLC患者治疗效果及预后的关系,为NSCLC患者的合理治疗提供依据。方法选取山东省肿瘤医院外科六病区2008-08-01-2012-08-31行手术切除且术后病理确诊为NSCLCⅡA~ⅢA期的患者106例,所有患者术前均未接受任何针对肿瘤的治疗措施,均釆用免疫组化技术测定组织中ERCC1和RRM1表达状况,术后均采用长春瑞滨联合顺铂(NP方案)进行辅助化疗,并进行临床随访。结果 NSCLC癌组织及转移淋巴结中RRM1阴性表达患者中位无疾病进展时间分别为23.1和24.7个月,显著优于RRM1阳性表达患者的16.4和19.1个月,两组比较差异有统计学意义,P值分别为0.007和0.026;而ERCC1阴性表达患者中位无疾病生存期为17.5个月,与ERCC1阳性表达患者的19.4个月比较,差异无统计学意义,P=0.59。原发灶和淋巴结转移灶中ERCC1和RRM1的表达水平差异无统计学意义,P>0.05。不同性别、分期及病理类型的NSCLC患者ERCC1及RRM1表达水平差异均无统计学意义,P>0.05。结论 NSCLC患者癌组织及转移淋巴结中,RRM1基因表达情况可作为NP方案术后辅助化疗预后的重要指标。
Objective To compare excision repair cross-complementation group 1 (ERCC1) and ribonucleotide reductase M1 subunit in primary tumor and metastatic lymph node in patients with non-small cell lung cancer (NSCLC) To investigate the relationship between the expression of ERCC1 and RRM1 and the therapeutic effect and prognosis of patients with NSCLC and to provide the basis for rational treatment of NSCLC patients. Methods Tumor Hospital of Shandong Province surgical six ward 2008-08-01 2012-08-31 Surgical resection and postoperative pathology diagnosed as NSCLC Ⅱ A ~ Ⅲ A of 106 patients, all patients were not receiving any tumor-targeted All the patients were treated with vinorelbine and cisplatin (NP regimen) for adjuvant chemotherapy after operation and clinical follow-up. Results The median progression-free time of patients with negative expression of RRM1 in NSCLC tissues and metastatic lymph nodes were 23.1 and 24.7 months, respectively, which were significantly better than those of RRM1 positive patients at 16.4 and 19.1 months. There was significant difference between the two groups Respectively. The median disease-free survival of patients with ERCC1 negative expression was 17.5 months, which was no significant difference compared with 19.4 months of ERCC1-positive patients (P = 0.59). There was no significant difference in the expression of ERCC1 and RRM1 between primary and lymph node metastasis (P> 0.05). There was no significant difference in the expression of ERCC1 and RRM1 in NSCLC patients of different genders, stages and pathological types (P> 0.05). Conclusion The expression of RRM1 gene in NSCLC patients with metastatic lymph nodes may serve as an important prognostic indicator for postoperative adjuvant chemotherapy with NP regimen.