ERCC1、RRM1预测NSCLC患者GP方案化疗敏感性的对比研究
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Comparison study with ERCC1 and RRM1 to predict clinical efficacy of chemotherapy in NSCLC patients
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    目的:对比切除修复交叉互补基因1(excision repair cross-complementing rodent repair deficiency,complementation group1,ERCC1)和核苷酸还原酶M1(ribonucleotide reductase M1,RRM1)低表达患者选择健择联合顺铂(gemcitabine and cisplatin,GP)方案和未经筛选经验性选用GP方案治疗晚期非小细胞肺癌(non-small-cell lung carcinoma,NSCLC)的临床疗效。方法:采用前瞻性的方法,根据组织标本是否适宜使用免疫组织化学方法检测分子标志物,在确诊为晚期NSCLC的患者中,ERCC1和RRM1低表达者归为A组,未经分子标志物检测的经验治疗者归为B组,经过4~6个周期的GP方案化疗,观察两组的疗效-无进展生存期(progressive-free survival,PFS)-总生存期(overall survival,OS)及化疗过程中的不良反应。结果:基于分子标志物结果选用GP方案较经验性选用GP方案有效率明显提高(χ2 = 5.377,P = 0.02),PFS明显延长(P = 0.03),差异有统计学意义;两组OS无显著性差异;不良反应无明显差异。结论:对ERCC1和RRM1低表达患者选择GP方案可以明显提高化疗有效率。

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    Objective:To compare the clinical efficacy of chemotherapy in late stage NSCLC by two types of methodologies:selective gemcitabine and cisplatin (GP)treatment based on ERCC1 and RRM1 low expression vs. non-selective standard treatment. Methods:This prospective,open study was based on whether target tissue is appropriate for immunohistochemical detection of molecular markers. The enrolled late stage NSCLC patients were divided into two groups,including the group A:low expression in ERCC1 and RRM1 markers,and the group B:no molecular marker pre-selection. After 4-6 weeks treatment with GP chemotherapy,the clinical outcome,progressive-free survival(PFS),overall survival(OS)and toxic/adverse reactions from chemotherapy were compared between the two groups. Results:The Group A (GP method based on ERCC1 and RRM1)has shown significant improvement in efficacy (χ2 = 5.377,P = 0.02) as well as statistically significant extension in PFS (P = 0.03)comparing to the Group B. There was no significant difference in OS and toxic/adverse reactions between the two groups. Conclusion:GP chemotherapy method which selected based on ERCC1 and RRM1 low expression could significantly improve the efficacy and PFS in patients of NSCLC late stage.

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张 蔷,朱晓莉,张 立,林 勇. ERCC1、RRM1预测NSCLC患者GP方案化疗敏感性的对比研究[J].南京医科大学学报(自然科学版),2013,(1):105-109

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  • 收稿日期:2012-09-21
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  • 在线发布日期: 2013-03-25
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