Association Of ERCC1、RRM1、TUBB3 Protein Expression With Chemotherapy Effect And Prognosis In Elderly Advanced NSCLC Patients

Purpose: The aim of this study to investigate the expression of ERCC1、RRM1、TUBB3 protein in elderly advanced NSCLC patients, verify the relationship between ERCC1、RRM1、TUBB3 with gender、smoking history、pathological pattern、clinical stages、performance status,and then investigate the correlation between these gene expression level and the efficacy of platinum- gemcitabine or paclitaxel chemotherapy、prognosis in elderly advanced NSCLC patients.Method:A total of 77 elderly patients(age≥60) diagnosed with IIIB and IV stage NSCLC by histology,who were treated with first-line platnum-based chemotherapy,served as the study objects,these patients come from Shaanxi province cancer hospital in 2012.1~2014.12.Retrospectively analyzed those clinical medical records and pathological features, And collect the tumor tissue samples,the protein expression level of ERCC1,RRM1,and TUBB-3 were assessed by immunohistochemistry,the outcome are negative(-),low expression(+),medium expression(++) and high expression(+++) respectively.Statistics chemotherapy efficiency, progression-free survival(PFS), overall survival(OS) and 3-year survival rate,the last follow-up time is 2014.12.31,using SPSS 21.0 software for statistical analysis.Result: 1.The positive expression of ERCC1、RRM1、TUBB-3 protein in 77 cases was 68.8%、85.7%、79.2% respectively;2.There was no significant difference between the ERCC1,RRM1,TUBB-3 expression with gender, smoking history,pathological pattern、clinical stages.(P﹥0.05);3.The response rate of chemotherapy was 33.3%, median survival time was12 months, one-year survival rate was82.2% for patients with ERCC1-negative expression,and 26.4%,6 months,and64.7%for patients with ERCC1-positive expression, respectively. Patients with negative expression of ERCC1 had better chemotherapy efficiency,longer overall survival than patients with positive expression.(P<0.05);4.The response rate of chemotherapy was 36.4%,median survival time was12 months, one-year survival rate was 81.8%for patients with RM1-negative expression, and 27.3%,8months, and69.5% for patients with RRM1-positive expression,respectively. Patients with negative expression of RRM1 had better chemotherapy efficiency,longer overall survival than patients with positive expression.(P<0.05);5.The response rate of chemotherapy was 37.5%,median survival time was12 months, one-year survival rate was 87.1%for patients with TUBB3-negative expression,and 27.9%,7 months,and 65.4% for patients with TUBB3-positive expression,respectively. Patients with negative expression of TUBB3 had better chemotherapy efficiency,longer overall survival than patients with positive expression.(P<0.05);6.For patients who treated with platinum-gemcitabine,the median survival time was16 months,one-year survival rate was75.0%for patients with RRM1-negative expression,and 14 months,with60.0% for patients with RRM1-positive expression,respectively. Patients with negative expression of RRM1 had longer overall survival than patients with positive expression.(P<0.05);7.For patients who treated with platinum-paclitaxel,the median survival time was17 months,one-year survival rate was 83.3%for patients with TUBB3-negative expression,And15 months,with 70.6% for patients with TUBB3-positive expression,respectively. Patients with negative expression of TUBB3 had longer overall survival than patients with positive expression.(P<0.05);Conclusion: 1.There was no significant difference between the ERCC1,RRM1,TUBB-3 expression with gender, smoking history,pathological pattern、clinical stages、performance status. 2.ERCC1,RRM1,TUBB3 cloud be a useful biomarker to predict clinical outcome in elderly patients with advanced NSCLC receiving first-line platinum-gemcitabine or paclitaxel chemotherapy. Has important guiding significance for the treatment of elderly advanced NSCLC. 3.The expression level of RRM1 can be used as a biomarker to treat with gemcitabine and judge prognosis in elderly advanced patients. 4.The expression level of TUBB3 can be used as a biomarker to choose paclitaxel chemotherapy and judge prognosis in elderly advanced patients.