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[目的]探讨切除修复交叉互补基因1(excision repair cross complement group1,ERCC1)、拓扑异构酶-1(Topo1)指导化疗药物个体化选择在晚期结直肠癌患者的疗效和安全性。[方法]采用实时荧光定量RT-PCR,检测178例晚期结直肠癌患者中ERCC1、TOPO1表达情况,分为实验组、对照组,分析化疗疗效,并作生存分析。[结果](1)肿瘤组织和外周血淋巴细胞中ERCC1、TOPO1表达水平呈正相关(r=0.615、0.508)。(2)第1组(实验组):根据ERCC1、TOPO1表达水平选择化疗方案,第2组(对照组)。实验组临床有效率为51.6%(32/62),与对照组疗效比较,差异有统计学意义(χ2=4.052,P<0.05);生存分析显示,实验组与对照组的TTP分别为10.9个月和7.1个月,P<0.05,MST分别为15.8个月和12.2个月,P<0.05,差异有统计学意义。[结论]联合检测ERCC1mRNA、TOPO1mRNA的表达水平,可为结直肠癌患者个体化化疗方案的制定提供参考依据。
[Objective] To investigate the efficacy and safety of excision repair cross complement group 1 (ERCC1) and topoisomerase-1 (Topo1) in guiding individualized choice of chemotherapeutics in patients with advanced colorectal cancer. [Methods] The expression of ERCC1 and TOPO1 in 178 patients with advanced colorectal cancer were detected by real-time fluorescent quantitative RT-PCR. The patients were divided into experimental group and control group, and the curative effect of chemotherapy was analyzed. [Results] (1) The expression of ERCC1 and TOPO1 in tumor tissue and peripheral blood lymphocytes was positively correlated (r = 0.615,0.508). (2) Group 1 (experimental group): According to ERCC1, TOPO1 expression level selection chemotherapy, group 2 (control group). The clinical effective rate was 51.6% (32/62) in the experimental group, with significant difference compared with the control group (χ2 = 4.052, P <0.05). The survival analysis showed that the TTP of the experimental group and the control group were 10.9 Month and 7.1 months, P <0.05, MST were 15.8 months and 12.2 months, P <0.05, the difference was statistically significant. [Conclusion] The combined detection of ERCC1 mRNA and TOPO1 mRNA expression may provide a reference for the development of individualized chemotherapy regimens in patients with colorectal cancer.