A Study On The Relation Of ERCC1 Expression And The Clinical Features, Prognosis And Cis-Platinum Adjuvant Chemotherapy In Non-Small Cell Lung Cancer Patients

Objective:1.To study the relation of excision repair cross-complementation group 1(ERCC 1) and the clinical features of non-small cell lung cancer patients,such as gender,age,smoking,lymph node metastasis,tumor T stages,TNM stages and histology category,and to understand the function of ERCC1 and other excision repair genes in the process of non-small cell lung cancer;2.To study the relation of ERCC1 protein expression and the survival rates of non-small cell lung cancer patients,and explore the possibility of using ERCC1 protein expression as a biomarker for prognosis of non-small cell lung cancer;3.To study the relation of ERCC 1 protein expression and cis-platinum base adjuvant chemotherapy in non-small cell lung cancer,focusing on the poor out come and resistance of cis-platinum based adjuvant chemotherapy in some of non-small cell lung cancer patients,prove the importance of testing ERCC1 expression level in guiding the cis-platinum base adjuvant chemotherapy.Method:We examined ERCC1 expression in 112 NSCLC patients by immunohistochemical staining of paraffin embedded tumor tissue.First,we analyzed the relation of ERCC1 expression and clinical features of NSCLC patients,such as age,gender,smoking,lymph node metastsis,tumor T stages,TNM stages,histology category.Second,we compared the survival rates and prognosis of non-small cell lung cancer patient with different clinical features,such as gender,age,smoking,lymph node metastasis,tumor T stages,TNM stages and histology category;we also compared the survival rates of no-small cell lung cancer patient with positive ERCC 1 protein expression and negative ERCC1 protein expression without taking clinical features as influence factors.3.We compared the effect of cis-platinum based adjuvant chemotherapy on the survival of non-small cell lung cancer patient with positive ERCC 1 protein expression and negative ERCC 1 protein expression.Results:1.The relation of ERCC1 and the clinical features of non-small cell lung cancer patients,such as gender,age,smoking,lymph node metastasis,tumor T stages,TNM stages and histology category:the study showed ERCC 1 expression was associated with gender,there was a significant difference in ERCC1 expression between male and female non-small cell lung cancer patients(P=0.04);ERCC1 expression was not associated with clinical features as age(P=0.96),smoking(P=0.87), lymph node metastasis(P=0.96),tumor T stages(P=0.98),TNM stages(P=0.37) and histology category(P=0.84).2.(1) With different ERCC1 protein expression,the results of comparison of survival rates of non-small cell lung cancer patients in different clinical feature groups showed:①In gender groups,there was no significant difference of the survival rates of male and female in non-small cell lung cancer patients with positive ERCC1 protein expression and negative ERCC1 protein expression,P=0.708 and 0.517.②In age groups,in non-small cell lung cancer patients with negative ERCC1 protein expression,the survival rates of age＜60 year-old patients was significantly higher than the survival rates of age≥60 year-old patients,P=0.03;in non-small cell lung cancer patients with positive ERCC1 protein expression,there was no significant difference between the survival rates of age＜60 year-old patients and the survival rates of age≥60 year-old patients,P=0.436,but there was a tendency that the survival rates of patients≥60 year-old was higher than the survival rates of patients＜60 year-old.③In smoking index groups,in non-small cell lung cancer patients with negative ERCC 1 protein expression,the survival rates of non-smoking group and＜400/year group was significantly higher than the survival rates of≥400/year group,P=0.027;in non-small cell lung cancer patients with positive ERCC1 protein expression,there was no significant difference among the survival rates of non-smoking group,＜400/year group and≥400/year group, P=0.499.④In tumor T stages groups,both in patients with positive ERCC1 protein expression and negative ERCC1 protein expression,the survival rates of T1 group was significantly higher than the survival rates of T2 stages group(P＜0.0001),the survival rates of T2 group was significantly higher than the survival rates of T3 stages group(P＜0.0003).⑤In different lymph node metastasis groups,in non-small cell lung cancer patients with negative ERCC1 protein expression,there was no significant difference of the survival rates of patients with lymph node metastasis and patients without lymph node metastasis,P=0.208;in non-small cell lung cancer patients with positive ERCC 1 protein expression,the survival rates of patients without lymph node metastasis was significantly higher than the survival of patients with lymph node metastasis,P=0.007.⑥In both ERCC1 positive NSCLC patients and ERCC 1 negative NSCLC patients,there was significant difference among the survival rates of patients at different TNM stages,the survival rates ofⅡstage is higher than the survival rates ofⅢstage(P=0.0001),the survival rates ofⅡstage is higher than the survival rates ofⅢstage(P=0.0006).⑦In both ERCC1 positive NSCLC patients and ERCC1 negative NSCLC patients,survival rate in patients with adenocarcinoma is higher than the survival rates in patients with squamous carcinoma(P=0.014 and P=0.01).(2) The association of ERCC1 protein expression and the survival rates in non-small cell lung cancer patients:there was no significant difference between the survival rates of ERCC1 protein positive patients and the survival rates of ERCC1 protein negative patients,P=0.23,but there was a tendency that the survival rates of ERCC1 protein positive patients was higher than the survival rates of ERCC1 protein negative patients.3.The association of ERCC1 protein expression and post surgery cis-platinum based adjuvant chemotherapy:in non-small cell lung cancer patients with positive ERCC1 protein expression,the survival rates of patients received cis-platinum chemotherapy was significantly lower than the survival rates of patients did not,P=0.01;in non-small cell lung cancer patients with negative ERCC1 protein expression,there was no significantly difference between the survival rates of patients received cis-platinum chemotherapy and the survival rates of patients did not (P＞0.05),but there was a tendency that former was higher than the later.Conclusion:1.In non-small cell lung cancer patients,ERCC1 expression is associated with gender,there was significant difference between male and femle, ERCC 1 expression is not associated with age,smoking index,lymph node metastasis, tumor T stages,TNM stages and tumor histology category.2.Non-small cell lung cancer patients with negative ERCC1 expression,patient＜60 year-old,smoking＜ 400/ year,with early tumor T stages and early TNM stages,with adenocarcinoma have higher survival rates and better prognosis;while in non-small cell lung cancer patients with positive ERCC 1 expression,patients≥60 year-old,smoking＜400/year, with early tumor T stages and early TNM stages,without lymph node metastasis,with adenocarcinoma have higher survival rates and better prognosis.ERCC1 could be a successful biomarker for prognosis of non-small cell lung cancer in addition to other clinical standard,such as tumor differentiation,histology category,TNM stages et al. 3.Those non-small cell lung cancer patients with negative ERCC1 expression may benefit from cis-platinum based post surgery chemotherapy.ERCC1 positive indicates the patient may be cis-platinum resistance.So ERCC1 expression can be used to guide the choice of cis-platinum based post surgery chemotherapy for non-small cell lung cancer patients.