A Study On The Relationship Between The ERCC1 Expression And The Effect Of Nedaplatin Treating Advanced Esophageal Cancer

Objective:Many studies show that the ERCC1(excision repair cross-complementation group 1) gene expression in the tissues of esophageal cancer are associated with the effect of platinum-based treatment on some solid tumors,such as non-small-cell lung cancer, colorectal cancer and ovarian cancer et al;And they could be predictive factors. Currently,"cisplatin plus fluorouracil"is one of the most frequently used chemotherapy regiments. But due to its smaller nephrotoxicity and gastroenteric reaction, nedaplatin,the second generation of plantinum agent, is being widely used in esophageal cancer chemotherapy at present. Therefore,in this study,we detected the ERCC1 gene expression of the advcanced esophageal cancer patients treated with nedaplatin-based chemotherapies, analyzed whether the expression level of ERCC1 and other clincal and pathological factors were related to DCR(disease control rate) and PFS(progression free survival).Methods:102 advanced esophageal cancer patients were retrospectively enrolled between December 2009 and December 2010 in Anhui provincial hospital. They were all treated with nedaplatin combined with fluorouracil chemotherapies. The DCR and PFS were assessd,and detected the ERCC1 expression lever in esophageal cancer tissues by immunohistochemisty. In the end,84 of 102 patients completed the trials and the data were available.Statistical anaysis was performed using SPSS statistical software package 17.0 with P≤0.05 considered as statistically signficant.Univariate ananysis by chi-square test and multivarariate analysis by logistic regression model were used for disease control rate. PFS curves were calculated accading to Kaplan-Meier method. Univariate ananysis by log-rank test and multivarariate analysis by Cox regression model were used for PFS.Results: In all 84 patients, the positive rate of ERCC1 expression was 88.1%(74/84) , The overall disease control rate was 36.9%(31/84), while overall disease control rate in negative group of ERCC1 expression was higher than positive group,there were 10 cases which expression level were less than 4,49 were ranged from 4 to 5,22 were ranged from 6 to 7,and 3 cases more than 8.There were 74 male and 10 female;47 patients were no yunger than 60 years,37 patients were yunger than 60 years; the pathological types of all were squamous cell carcinoma,and of 65 were poor to moderately differentiated,19 were well differentiated; there were 5 patients'KPS as 70,22 patients'KPS as 80 and 57 patients'KPS as 90; On univariate analysis,ERCC1 expression level and tumor differentiation level were related to DCR and PFS. On multivariate analysis,ERCC1 expression level and tumor differentiated were also related to DCR and PFS.Concolutions:Advanced esophageal cancer patients with ERCC1 negative(<4) or weakly positive(4～5) expression may have better DCR and PFS results than the others patients with ERCC1 strongly positive(≥5) expression; Meanwhile,the patients with tumor well-differentiation had batter DCR and PFS result than the others who had moderately and poor differentiation.