The Expression and Clinical Significance of Ercc1 in Human Gastric Cancer
|School||Dalian Medical University|
|Keywords||Gastric Cancer ERCC1 Clinical features Chemotherapy Prognosis|
Background and Objective: Gastric cancer death in the world, ranked second only to lung cancer. Prevalence of gastric cancer patients worldwide has exceeded 40%. Treatment of gastric cancer with surgery, but the five-year survival rate does not exceed 50% of postoperative adjuvant chemotherapy become the main method of treatment. Cisplatin is often used in gastric cancer adjuvant chemotherapy, cisplatin cytotoxicity mainly platinum-DNA adduct formation, inhibition of DNA replication and transcription. DNA repair mechanisms for resistance to platinum-based chemotherapy drugs plays a key role. Nucleotide excision repair cross complementing gene 1 (Excision Repair Cross-Complementation Group 1, ERCC1) involved in DNA chain cutting and damage identification. ERCC1 overexpression can arrest at G2 / M phase of rapid repair of damaged DNA, resulting in tumor cells resistant to platinum. ERCC1 gene expression in non-small cell lung cancer, the efficacy of platinum-based adjuvant chemotherapy and survival of patients are affected, in ovarian cancer, cervical cancer, bladder cancer, colorectal cancer and other malignancies have also studied, but patients with gastric cancer ERCC1 platinum-based chemotherapy response and survival effects reported less present on ERCC1 expression in gastric cancer patients with chemotherapy and survival relationship is unclear. In this study, the clinical reality, Immunohistochemistry was used to detect different ERCC1 protein in gastric tissue types whether there are differences in expression analysis ERCC1 protein expression and clinical characteristics and survival of gastric cancer, to explore the ERCC1 protein expression with platinum-based chemotherapy survival implications for individualized treatment of gastric cancer reference. MATERIALS AND METHODS: A retrospective study, to collect the January 1, 2002 to January 1, 2008 the Second Affiliated Hospital of Dalian Medical University, gastric cancer surgery 46 patients (including 16 cases of poorly differentiated gastric adenocarcinoma, gastric moderately differentiated adenocarcinoma, 19 cases of gastric signet ring cell carcinoma 11 cases) clinical data and pathological paraffin blocks were detected by immunohistochemistry in gastric ERCC1 protein expression in different tissue types, with the Mann-Whitney U test to compare different types of organizations ERCC1 expression rate of gastric whether there are differences. Using χ2 test and Spearman correlation analysis, analysis of ERCC1 protein expression and correlation of clinical features of gastric cancer. Analysis using the Kaplan-Meier method ERCC1 protein platinum-based adjuvant chemotherapy for patients with gastric cancer survival impact. Using SPSS17.0 software analysis, P lt; 0.05 considered statistically significant. Follow-up deadline is March 1, 2011. Result: gastric cancer cells, ERCC1 localized in the nucleus. 46 cases of gastric cancer, ERCC1 expression in 31 cases, the positive expression rate of 45.6%. Stomach differentiated adenocarcinoma, poorly differentiated adenocarcinoma and signet ring cell carcinoma histological type of gastric cancer in three kinds of expression of ERCC1 was no significant difference (P = 0.724). ERCC1 expression and gender, age, tumor size, tumor differentiation, depth of invasion, lymph node metastasis, TNM staging. Expression of ERCC1-positive and-negative patients with disease-free survival (DFS), were 26.2 months and 14.3 months, P = 0.313, the difference was not statistically significant. Expression of ERCC1-positive patients with a median survival (OS) 37.3 months, 20.1 months in patients with negative expression, P = 0.157, not statistically significant. ERCC1-positive patients receiving platinum-based chemotherapy compared with and without adjuvant chemotherapy, overall survival was 28.3 months and 44.1 months, P = 0.903, not statistically significant; ERCC1-negative expression in patients receiving platinum-based chemotherapy and No adjuvant chemotherapy compared overall survival was 20.1 months and 17.4 months, P = 0.956, not statistically significant. Conclusions: 1. ERCC1 expression and patient gender, age, tumor size, tumor differentiation, depth of invasion, lymph node metastasis, TNM staging. ERCC1 in different histological types of gastric carcinoma no difference. 2. ERCC1 expression better than those with negative expression survival trends. 3. ERCC1 expression did not predict radical gastrectomy received adjuvant chemotherapy in patients with platinum-based survival.