The Significance For Expression Of ERCC1, Survivin, BAX And VEGF In Early-Stage Non-Small Cell Lung Cancer

Background:Currently, a investigation of national resident inquest which released by the the Ministry of Health showed:in China, the malignant tumor is the first death cause of urban residents and it was one of the most serious diseases which are harmful to the health of human beings. The report also showed that the lung cancer caused mortality in the largest increase in the past30years had increased by about465%. At present, the treatment of lung cancer including surgery, chemotherapy, radiotherapy and immunotherapy treatment.Chemo-therapy as a systemic therapy means to malignant tumors can not be replaced by others. Long-term clinical experience summary and some large-scale clinical randomized controlled studies have developed a consensus:give a platinum-based adjuvant chemotherapy after complete resection of advanced non-small cell lung cancer can improve the survival rates, but for early-stage non-small cell lung cancer (NSCLC) that is still controversial. United States of Clinical Oncology annual meeting in2004showed that there was a12%increase in the survival rate of patients who were in Ib of NSCLC which given postoperative adjuvant carboplatin plus paclitaxel chemotherapy after complete resection by CALGB9633experimental group. However, the5-year follow-up data in2006showed that there was no statistically significant between the chemotherapy group and the non-chemotherapy group in5-year survival by the same experimental group. Some studies have shown that given postoperatively with platinum-based adjuvant chemotherapyr is not beneficial to the early-stage NSCLC patients while reduceing the quality of life of the patients. Even so, there are still some scholars believe that for young, healthy with early stage NSCLC patients if the tumor is large, having lymphatic infiltration, or having higher PET SUV values in preoperative examination is recommended for postoperative adjuvant chemotherapy.This researches believe that the molecular mechanisms of the patients has led to differences in the effect of NSCLC patients after adjuvant chemotherapy. Our study try to detect the expression for four genes of ERCC1, Survivin, Bax and VEGF in the early-stage NSCLC patients by real-time quantitative PCR in order to establish the molecular model to guide the postoperative treatment and develop "tailored" individualized treatment plan for early-stage NSCLC patients.This study is exploratory research that was to study the expression of ERCC1, surviving, bax and VEFG genes in tissue of NSCLC in early stage and explore the influence of its joint detection for post-operative chemotherapy. There is no domestic similar report has been published. Progresses of our research are as follows:(1) Preparation of recombinant plasmid of ERCC1, Survivin, Bax and VEGF genes which had been confirmed by sequencing was successful; And gene real-time quantitative PCR detection platform for above-mentioned genes had been successfully established.(2) There was no correlation between the expressions of ERCC1, Survivin, Bax and VEGF genes which were detected with qRT-PCR:ERCC1gene expression showed statistical difference between different tumor histological types (P<0.05) and no statistical difference between different histological staging (P>0.05); Survivin and VEGF genes expression showed no statistical difference during tumor histological types and histological staging; Bax gene expression showed statistical difference between different tumor histological types and histological staging (P<0.05)(3) After analyzing the data from87patients with COX regression analysis (expression levels of four genes, ages, gender, tumor histological types and TNM staging), the results indicated neither of them was the independent prognostic factor of NSCLC. The four genes expression showed statistical difference between the good prognosis group and bad prognosis group. The post-operative NSCLC patients with ERCC1(>8.56), Survivin (>6.26) high-expression and Bax (≤5.07), VEGF (<4.05) low-expression had a worse prognosis in chemotherapy.(4) The ERCC1, Survivin, Bax and VEGF can be observation indexes for early post-operative treatment and judgment of post-operative chemotherapy.