检测淋巴结中ERCC1蛋白指导非小细胞肺癌的个体化治疗

摘要

目的：探讨转移淋巴结中核苷酸切除修复交叉互补基因1（excision repair cross-complementation group1，ERCC1）蛋白的表达情况，以指导非小细胞肺癌（non-small cell lung cancer，NSCLC）进行个体化治疗的价值。方法96例通过淋巴结病理组织检查确诊为NSCLC的患者，分为标准治疗组38例，选择含铂类药物的一线化疗方案化疗；个体化治疗组58例，根据转移淋巴结组织中ERCC1蛋白的表达情况选择个体化化疗方案治疗。分析比较两个治疗组的化疗效果，以Kaplan-Meier法分析两个治疗组患者生存期的差异。结果在患者转移淋巴结中ERCC1蛋白表达的阳性率为51.7%。个体化治疗组和标准治疗组的化疗有效率分别为58.6%和34.2%（P=0.019），两组的中位生存期分别为9个月和7个月，个体化治疗组的疗效明显优于标准治疗组（P=0.039）。结论检测淋巴结中ERCC1蛋白的表达以指导NSCLC个体化治疗可以提高化疗效果，延长患者的生存时间。%Objective To detect expression of excision repair cross-complementation group 1(ERCC1)protein in metastatic lymph nodes of patients with advanced non-small cell lung cancer (NSCLC),and investigate whether the expression can be useful for individualizing therapy. Methods A total of 96 patients with pathologically proven NSCLC involving lymph node metastasis were randomized between one group receiving standard treatment group(n=38),which was first-line platinum-based chemotherapy;and another group receiving individualized treatment(n=58),based on ERCC1 protein detection.Treatment effectiveness and Kaplan-Meier survival curves were compared between the two groups. Results ERCC1 protein was expressed in the metastatic lymph nodes of 51.7% of 58 cases.The response rate was significantly higher in the individualized treatment group(58.6%)than in the standard treatment group (34.2%,P=0.019),as was median overall survival (9 vs 7 months,P=0.039). Conclusions Individualized therapy based on ERCC1 protein detection in metastatic lymph nodes was associated with greater curative effect and survival than was standard therapy.