ERCC1和Survivin对非小细胞肺癌患者化疗效果的预测价值
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摘要
目的探讨剪切修复偶联因子1(ERCC1)和存活蛋白(Survivin)对非小细胞肺癌患者化疗效果的预测价值。方法选择2015年1月到2017年1月在中国医科大学附属第四医院进行治疗的60例非小细胞肺癌患者资料进行回顾性分析,全部患者均给予化疗。检测ERCC1和Survivin在非小细胞肺癌患者中的表达,比较ERCC1和Survivin不同表达情况的化疗效果及生存情况。结果 ERCC1阴性患者的治疗效果优于ERCC1阳性患者,Survivin阴性患者的治疗效果优于Survivin阳性患者,差异均有统计学意义(χ~2=7.096、4.812,P均<0.05)。在16个月的随访中,38例患者死亡,病死率为63.33%。ERCC1阴性患者的生存时间为(11.92±4.23)月,ERCC1阳性患者的生存时间为(9.04±3.87)月,差异有统计学意义(χ~2=6.634,P<0.05)。Survivin阴性患者的生存时间为(12.58±3.87)月,Survivin阳性患者的生存时间为(9.77±4.89)月,差异有统计学意义(χ~2=4.931,P<0.05)。患者的年龄偏大、吸烟、分化程度较低、临床分期较高、ERCC1的表达为阳性、Survivin的表达为阳性,是经过化疗的非小细胞肺癌患者预后的影响因素(RR=2.349、10.216、6.378、26.258、7.729、8.837,P均<0.05)。结论 ERCC1和Survivin的表达与非小细胞肺癌患者的化疗效果和预后密切相关,可纳入对该种类疾病患者的疗效与预后推断的预测因子中。
Objective To investigate the predictive value of ERCC1 and survivin in the chemotherapy effect of patients with non-small cell lung cancer. Methods A retrospective analysis of 60 patients with non-small cell lung patients who were treated at the Fourth Affiliated Hospital of China Medical University between January 2015 and January 2017 was performed.All patients were given chemotherapy. The predictive values of ERCC1 and survivin in the chemotherapy effect of patients with non-small cell lung cancer were analyzed. Results The treatment effect of ERCC1 negative patients was better than that of ERCC1 positive patients;the treatment effect of survivin negative patients were better than survivin positive patients(χ~2=7.096,4.812,P<0.05). At 16 months of follow-up,38 patients died and the case fatality rate was 63.33%. The survival time of ERCC1-negative patients was(11.92±4.23)months,and the survival time of ERCC1-positive patients was(9.04±3.87)months. The data were statistically significant(χ~2=6.634,P<0.05). Survivin-negative patients had a survival time of(12.58±3.87)months,and survivin-positive patients had a survival time of(9.77±4.89)months. The difference between the two groups was statistically significant(χ~2=4.931,P<0.05). Patients with older age,smoking,lower degree of differentiation of the cancer cells,higher clinical stage,ERCC1 positive and survivin positive were the prognostic factor of patients with non-small cell lung cancer after chemotherapy(RR=2.349,10.216,6.378,26.258,7.729,8.837,P<0.05).Conclusion The expressions of ERCC1 and survivin were closely related to the effect of chemotherapy and prognosis in non small cell lung cancer patients. It is worthy of in-depth study and may be included in the predictors of the efficacy and prognosis of the patients of this kind of disease.
Objective To investigate the predictive value of ERCC1 and survivin in the chemotherapy effect of patients with non-small cell lung cancer. Methods A retrospective analysis of 60 patients with non-small cell lung patients who were treated at the Fourth Affiliated Hospital of China Medical University between January 2015 and January 2017 was performed.All patients were given chemotherapy. The predictive values of ERCC1 and survivin in the chemotherapy effect of patients with non-small cell lung cancer were analyzed. Results The treatment effect of ERCC1 negative patients was better than that of ERCC1 positive patients;the treatment effect of survivin negative patients were better than survivin positive patients(χ~2=7.096,4.812,P<0.05). At 16 months of follow-up,38 patients died and the case fatality rate was 63.33%. The survival time of ERCC1-negative patients was(11.92±4.23)months,and the survival time of ERCC1-positive patients was(9.04±3.87)months. The data were statistically significant(χ~2=6.634,P<0.05). Survivin-negative patients had a survival time of(12.58±3.87)months,and survivin-positive patients had a survival time of(9.77±4.89)months. The difference between the two groups was statistically significant(χ~2=4.931,P<0.05). Patients with older age,smoking,lower degree of differentiation of the cancer cells,higher clinical stage,ERCC1 positive and survivin positive were the prognostic factor of patients with non-small cell lung cancer after chemotherapy(RR=2.349,10.216,6.378,26.258,7.729,8.837,P<0.05).Conclusion The expressions of ERCC1 and survivin were closely related to the effect of chemotherapy and prognosis in non small cell lung cancer patients. It is worthy of in-depth study and may be included in the predictors of the efficacy and prognosis of the patients of this kind of disease.
引文
[1]徐秋萍,何斐,刘志强,等.性别对非小细胞肺癌预后的影响分析[J].中华流行病学杂志,2017,38(2):244-247.
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[3]张颖,魏简汇,翟保同,等.叶酸联合维生素B12对非小细胞肺癌患者化疗疗效的影响[J].中国现代医学杂志,2018,28(2):102-105.
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[5]李萍,马薇,周荣,等.非小细胞肺癌靶向治疗药物的研究进展[J].药学与临床研究,2017,25(2):130-136.
[6]张纪良,青小燕,曾晓梅,等.洛铂联合多西他赛治疗晚期非小细胞肺癌疗效的观察[J].中国医药导刊,2017,19(2):165-167.
[7]朱丽华,陈尚雅,李和根,等.晚期非小细胞肺癌中医药联合外治法的临床研究[J].世界中医药,2017,12(1):34-36,41.
[8]丁晓权,毕鑑红,马志刚,等.食管癌组织中ERCC1和GSTP1表达量与铂类化疗药物敏感性及凋亡、增殖基因表达量的相关性[J].海南医学院学报,2017,23(6):809-812.
[9]郑春雷,张忠泰,高红.胃癌组织中生存素和基质金属蛋白酶-9的表达及其与胃癌临床病理特点的关系[J].中华实验外科杂志,2017,34(2):214-216.
[10] Wachters FM,Wong LS,Timens W,et al. ERCC1,hRad51,and BRCA1 protein expression in relation to tumour response and survival of stageⅢ/ⅣNSCLC patients treated with chemotherapy[J]. Lung Cancer,2005,50(2):211-219.
[11] Tanaka K,Iwamoto S,Gon G,et al. Expression of survivin and its relationship to loss of apoptosis in breast carcinomas[J]. Clin Cancer Res,2000,6(1):127-134.
[12]罗宴吉,王猛,陈洁,等. RECIST 1.1与Choi标准在舒尼替尼治疗胃肠胰神经内分泌肿瘤早期疗效评估的比较[J].影像诊断与介入放射学,2017,26(2):97-102.
[13] An HJ,Jo H,Jung CK,et al. Prognostic implication of ERCC1protein expression in resected oropharynx and oral cavity cancer[J]. Pathol Res Pract,2017,213(8):949-955.
[14] Huang MY,Huang JJ,Huang CM,et al. Relationship between expression of proteins ERCC1,ERCC2,and XRCC1 and clinical outcomes in patients with rectal cancer treated with FOLFOXBased preoperative chemoradiotherapy[J]. World J Surg,2017,41(11):2884-2897.
[15] Geng J,Lei YR,Pei SG. Correlation between Survivin expression and laryngeal carcinoma:a meta-analysis[J]. J Huazhong Univ Sci Technolog Med Sci,2017,37(6):965-973.
[16] Tiefenbck-Hansson K,Haapaniemi A,Farnebo L,et al.WRAP53β,survivin and p16INK4a expression as potential predictors of radiotherapy/chemoradiotherapy response in T2N0-T3N0 glottic laryngeal cancer[J].Oncol Rep,2017,38(4):2062-2068.
[17] Xu Q,Zhang Z,Sun W,et al. Haplotype analysis on relationship of ERCC2 and ERCC3 gene polymorphisms with osteosarcoma risk in Chinese young population[J]. Mamm Genome,2017,28(5):227-233.
[2]李玺,林劲松,陈桂阳,等. EBUS-TBNA标本检测6种miRNA对非小细胞肺癌诊断和分型的意义[J].国际呼吸杂志,2017,37(2):90-95.
[3]张颖,魏简汇,翟保同,等.叶酸联合维生素B12对非小细胞肺癌患者化疗疗效的影响[J].中国现代医学杂志,2018,28(2):102-105.
[4]韩轲,杨海棠,范力文,等.混合型小细胞肺癌外科治疗后预后分析[J].中国肿瘤临床,2017,44(7):331-336.
[5]李萍,马薇,周荣,等.非小细胞肺癌靶向治疗药物的研究进展[J].药学与临床研究,2017,25(2):130-136.
[6]张纪良,青小燕,曾晓梅,等.洛铂联合多西他赛治疗晚期非小细胞肺癌疗效的观察[J].中国医药导刊,2017,19(2):165-167.
[7]朱丽华,陈尚雅,李和根,等.晚期非小细胞肺癌中医药联合外治法的临床研究[J].世界中医药,2017,12(1):34-36,41.
[8]丁晓权,毕鑑红,马志刚,等.食管癌组织中ERCC1和GSTP1表达量与铂类化疗药物敏感性及凋亡、增殖基因表达量的相关性[J].海南医学院学报,2017,23(6):809-812.
[9]郑春雷,张忠泰,高红.胃癌组织中生存素和基质金属蛋白酶-9的表达及其与胃癌临床病理特点的关系[J].中华实验外科杂志,2017,34(2):214-216.
[10] Wachters FM,Wong LS,Timens W,et al. ERCC1,hRad51,and BRCA1 protein expression in relation to tumour response and survival of stageⅢ/ⅣNSCLC patients treated with chemotherapy[J]. Lung Cancer,2005,50(2):211-219.
[11] Tanaka K,Iwamoto S,Gon G,et al. Expression of survivin and its relationship to loss of apoptosis in breast carcinomas[J]. Clin Cancer Res,2000,6(1):127-134.
[12]罗宴吉,王猛,陈洁,等. RECIST 1.1与Choi标准在舒尼替尼治疗胃肠胰神经内分泌肿瘤早期疗效评估的比较[J].影像诊断与介入放射学,2017,26(2):97-102.
[13] An HJ,Jo H,Jung CK,et al. Prognostic implication of ERCC1protein expression in resected oropharynx and oral cavity cancer[J]. Pathol Res Pract,2017,213(8):949-955.
[14] Huang MY,Huang JJ,Huang CM,et al. Relationship between expression of proteins ERCC1,ERCC2,and XRCC1 and clinical outcomes in patients with rectal cancer treated with FOLFOXBased preoperative chemoradiotherapy[J]. World J Surg,2017,41(11):2884-2897.
[15] Geng J,Lei YR,Pei SG. Correlation between Survivin expression and laryngeal carcinoma:a meta-analysis[J]. J Huazhong Univ Sci Technolog Med Sci,2017,37(6):965-973.
[16] Tiefenbck-Hansson K,Haapaniemi A,Farnebo L,et al.WRAP53β,survivin and p16INK4a expression as potential predictors of radiotherapy/chemoradiotherapy response in T2N0-T3N0 glottic laryngeal cancer[J].Oncol Rep,2017,38(4):2062-2068.
[17] Xu Q,Zhang Z,Sun W,et al. Haplotype analysis on relationship of ERCC2 and ERCC3 gene polymorphisms with osteosarcoma risk in Chinese young population[J]. Mamm Genome,2017,28(5):227-233.