Association Of Expression Of ERCC1/RRM1 With Survival And Resistance To Platinum Inpatients With Ⅰ-ⅢA NSCLC

Objective:To investigate the relationship between the expression level of excision repair cross—complementing gene-1(ERCCI)and ribonucleofide reductase subunit M1(RRM1)in resected stageⅠ-ⅢA patients with Non-small cell lung cancer(NSCLC)and the postoperative survival time and the platinum-containing chemotherapy sensitivity, and to provides a theoretical basis for individualized treatment of postoperative patients in NSCLC.Materials and methods:1.167 case stageⅠ-ⅢA patients with NSCLC, it have surgical treatment and postoperative chemotherapy from 2004 to 2007 in our hospital, were selected randomly and followed up after clinic datum were reviewed, 160 case were included in our study.2.The expression of ERCC1/RRM1 were determined by immunohistochemistry in the paraffin-embedded tumor specimens of the 160 specimens.3.Proportions were compared by Chi-square test, Survival curves were produced and median survival times were estimated using the method of Kaplan-Meier. Comparisons of the survival curves of groups were based on the log-rank test. Cox proportional hazards regression was used for Multivariate analysis.To explore the association between ERCC1 and RRM1 using Spearman analysis.Results:1.The positive expression rates of ERCC1and RRM1 in the NSCLC tissue were 55% and 49%.2.The expression of ERCC1 is no statistically significant difference With age/sex/smoking index/pathological type/lymph node metastases (P>0.05), but It is statistically significant difference With the differentiation(P=0.04), And the lower the degree of differentiation showed higher positive rate; The expression of RRMl is no statistically significant difference with age/sex/smoking index/pathological type/lymph node metastases/differentiation (P>0.05).3.Among all stageⅠ-ⅢA patients , the survival time in group with high expression of ERCC1 or RRM1 is no statistically significant difference with Low expression group survival(P> 0.05).4.Among stageⅠp atients ,the survival of ERCC1-positive group is longer than the negative group, but it have no statistically significant difference (P> 0.05). The survival of RRM1-positive group is longer than the negative group, the difference is statistically significant (P = 0.03);Ⅱ-ⅢA patients, the survival of ERCC1- Negative group is longer than positive group survival,the difference is statistically significant (P = 0.03), RRM1-positive survival is longer than the negative group,difference is no statistically significant (P> 0.05).5.In stageⅠpatients,the survival of non-chemotherapy is longer than the chemotherapy group survival in ERCC1/RRM1- positive,but the difference is no statistically significant (P> 0.05); In ERCC1/RRM1-negative,the survival of without chemotherapy is longer than the chemotherapy group, the difference is no statistically significant (P> 0.05).6.In stageⅡ-ⅢA patients, the survival of GP-chemotherapy is longer than the other chemotherapy with platinum group in RRM1-negative, the difference is no statistically significant (P = 0.21); In RRM1–positive, The survival of the those chemotherapy with platinum group is longer than the GP-chemotherapy group, the difference is on statistically significant (P = 0.12).7.Multivariant analyses showed the pathological type/lymph node metastases/ differentiation were independent prognostic factor of NSCLC.Conclusion:1.The expression of ERCC1 is no statistically significant difference With age/ sex/smoking index/pathological type lymph node metastases, but It is statistically significant difference With the differentiation;The expression of RRMl is no statistically significant difference with age/sex/smoking index/pathological type/lymph node metastases/differentiation.2.StageⅠN SCLC patients can not benefit from chemotherapy.3.In stageⅡ-ⅢA NSCLC patients,the expression of ERCC1 may be associatated with the sensitivity to platinum-based chemotherapy , patients with low expression of ERCC1 can benefit from platinum-based chemotherapy.4.The NSCLC patients with low expression of RRM1 can benefit from postoperative cisplatin plus gemcitabine chemotherapy. 5.The expression of ERCC1 is statistically significant difference With the expression of RRMl.