ERCC1和Ki67表达与乳腺癌患者含铂类化疗方案敏感性的关系

摘要

Objective To investigate the expressions of excision repair cross complementation group 1 ( ERCC1) and Ki67 in patients with breast cancer, and the relationships between their expressions and sensitivity of platinum-based chemotherapy. Methods Totally, 129 cases were pathologically diagnosed as breast cancer.Paclitaxel and carboplatin were used simultaneously. Chemotherapy regimen was as follows:Gemcitabine 1 000 mg��( m2 )-1 , IV drop on day 1 and 8;cisplatin 25 mg��( m2 )-1 , IV drop on day 1-3, for six cycles ( 21 days a cycle ) . ERCC1 and Ki67 expression in tumor tissue was observed by immunohistochemical analysis.Platinum-based chemotherapy sensitivity and survival of patients with different levels of ERCC1 and Ki67 expression were analyzed. Results In 129 patients, 18 cases were ERCC1 and Ki67 double-negative ( ERCC1-Ki67-) , and the clinical effective rate and 3-year cumulative survival rate were 88.89%and 83.33%, respectively.Twenty-four cases were ERCC1 positive but Ki67 negative ( ERCC1+Ki67-) , and the clinical effective rate and 3-year cumulative survival rate were 50. 00% and 62.50%, respectively.Thirty-three cases were ERCC1 negative but Ki67 positive (ERCC1-Ki67+), and the clinical effective rate and 3-year cumulative survival rate were 54. 55% and 60. 60%, respectively. Fifty-four patients were ERCC1 and Ki67 double-positive ( ERCC1+Ki67+) , and the clinical effective rate and 3-year cumulative survival rate were 22.78% and 31. 48%, respectively.Compared with ERCC1-Ki67- group, the clinical treatment efficiencies of cisplatin-based chemotherapy in ERCC1+Ki67- group, ERCC1-Ki67+ group, and ERCC1+Ki67+ group were significantly decreased ( P<0. 05 ) . The clinical treatment efficiency in patients of ERCC1+Ki67+ group with cisplatin-based chemotherapy was significantly decreased as compared with ERCC1+Ki67- group and ERCC1-Ki67+ group (P<0.05).Compared with ERCC1- Ki67- group, three-year cumulative survival rate in patients of ERCC1+ Ki67- group and ERCC1- Ki67+ group, ERCC1+Ki67+ group was significantly decreased ( P<0. 05 ) . Compared with ERCC1+Ki67-group and ERCC1-Ki67+group, three-year cumulative survival rate in patients of the ERCC1+Ki67+group was significantly decreased ( P<0.05) . Conclusion The expression levels of ERCC1 and Ki67 in breast cancer were high. Their expression levels are closely related with clinical efficiency of platinum-based chemotherapy.%目的：探讨核苷酸切除修复交叉互补基因1( ERCC1)和Ki67的表达与乳腺癌患者含铂类化学治疗(化疗)方案敏感性的关系。方法经病理学确诊乳腺癌患者129例，均行紫杉醇和卡铂联合化疗方案。吉西他滨1000 mg��( m2)－1，静脉滴注30 min，第1，8天；顺铂25 mg��( m2)－1，静脉滴注，第1~3天；21 d为1个周期，化疗6个周期。采用免疫组化分析患者肿瘤组织中ERCC1和Ki67的表达，并比较ERCC1和Ki67不同表达水平的患者对铂类化疗方案的敏感性和对铂类方案化疗患者生存的影响。结果129例患者中，ERCC1－Ki67－患者18例，临床有效率88.89％，3年累积生存率83.33％；ERCC1＋Ki67－患者24例，临床有效率50.00％，3年累积生存率62.50％；ERCC1－Ki67＋患者33例，临床有效率54.55％，3年累积生存率60.60％；ERCC1＋Ki67＋54例，临床有效率22.78％，3年累积生存率31.48％。与ERCC1－Ki67－组比较，ERCC1＋Ki67－组、ERCC1－Ki67＋组和ERCC1＋Ki67＋组患者对顺铂为基础的化疗方案的临床有效率明显下降( P<0.05)。 ERCC1＋Ki67＋组较ERCC1＋Ki67－组和ERCC1－Ki67＋组也显著下降( P<0.05)。与ERCC1＋Ki67－组和ERCC1－Ki67＋组比较，ERCC1＋Ki67＋组患者3年累积生存率明显下降(P<0.05)，而ERCC1＋Ki67－组和ERCC1－Ki67＋组比较差异无统计学意义( P>0.05)。 ERCC1＋Ki67－组和ERCC1－Ki67＋组患者3年累积生存率明显低于ERCC1－Ki67－组( P<0.05)。结论 ERCC1和Ki67在乳腺癌组织中表达水平较高，与患者铂类化疗药物的临床有效率密切相关。