刘海涛, 陈余清, 李殿明, 李伟, 王效静, 黄礼年, 闵生萍, 张永, 徐晓玲, 孙耕耘. RRM1、-Tubb3、ERCC1表达在Ⅲb/Ⅳ期非小细胞肺癌个体化治疗中的研究[J]. 蚌埠医学院学报, 2013, 37(12): 1541-1544,1547.
    引用本文: 刘海涛, 陈余清, 李殿明, 李伟, 王效静, 黄礼年, 闵生萍, 张永, 徐晓玲, 孙耕耘. RRM1、-Tubb3、ERCC1表达在Ⅲb/Ⅳ期非小细胞肺癌个体化治疗中的研究[J]. 蚌埠医学院学报, 2013, 37(12): 1541-1544,1547.
    LIU Hai-tao, CHEN Yu-qing, LI Dian-ming, LI Wei, WANG Xiao-jing, HUANG Li-nian, MIN Sheng-ping, ZHANG Yong, XU Xiao-ling, SUN Geng-yun. The significance of the RRM1,-Tubb3 and ERCC1 expressions in the individual treatment of stage Ⅲb/Ⅳ non-small cell lung cancer[J]. Journal of Bengbu Medical College, 2013, 37(12): 1541-1544,1547.
    Citation: LIU Hai-tao, CHEN Yu-qing, LI Dian-ming, LI Wei, WANG Xiao-jing, HUANG Li-nian, MIN Sheng-ping, ZHANG Yong, XU Xiao-ling, SUN Geng-yun. The significance of the RRM1,-Tubb3 and ERCC1 expressions in the individual treatment of stage Ⅲb/Ⅳ non-small cell lung cancer[J]. Journal of Bengbu Medical College, 2013, 37(12): 1541-1544,1547.

    RRM1、-Tubb3、ERCC1表达在Ⅲb/Ⅳ期非小细胞肺癌个体化治疗中的研究

    The significance of the RRM1,-Tubb3 and ERCC1 expressions in the individual treatment of stage Ⅲb/Ⅳ non-small cell lung cancer

    • 摘要: 目的:探讨Ⅲb/Ⅳ期非小细胞肺癌(NSCLC)组织中核苷酸还原酶M1(RRM1)、人微管蛋白3(-Tubb3)和核苷酸切除修复互补基因1(ERCC1)表达与吉西他滨、紫杉类和铂类药物疗效之间的关系。方法:Ⅲb/Ⅳ期NSCLC患者480例,随机分为试验组和对照组各240例,试验组采用实时荧光定量聚合酶链反应-高分辨溶解曲线法检测石蜡组织标本中RRM1、-Tubb3、ERCC1 mRNA的表达,并根据RRM1、-Tubb3表达结果,试验组选择铂类联合吉西他滨(GP方案)、长春瑞滨(NP方案)、紫杉醇(TP方案)或培美曲赛的两药化疗方案;对照组随机给予任何一种两药联合化疗。比较2组化疗疗效及总生存期。结果:试验组和对照组的客观缓解率分别为66.1%和31.7%,疾病控制率分别为79.7%和46.3%,差异均有统计学意义(P0.01);总生存期分别为11.2个月和9.8个月,差异无统计学意义(P0.05)。GP方案治疗后试验组患者客观缓解率为70.7%,较对照组32.6%显著增高(P0.01)。NP、TP方案治疗后试验组患者客观缓解率为66.7%,较对照组29.5%显著增高(P0.01)。试验组ERCC1低表达与高表达患者客观缓解率分别为78.7%和50.9%,差异有统计学意义(P0.01),低表达与高表达生存期分别11.4个月和10.9个月,差异无统计学意义(P0.05)。结论:依据RRM1、-Tubb3表达水平指导Ⅲb/Ⅳ期NSCLC个体化治疗较随机选用标准一线化疗方案可明显提高客观缓解率。

       

      Abstract: Objective: To investigate the relationship between the expressions of human tubulin beta-3 Chain( -Tubb3), ribonucleotide reductase 1( RRM1) and excision repair cross compementation 1( ERCC1) in stage Ⅲb / Ⅳ non-small cell lung cancer( NSCLC) and treatment effects with gemcitabine,taxanes and platinum. Methods: Four hundred and eighty patients with stage Ⅲb/Ⅳ NSCLC were randomly divided into the test group and control group( 240 cases each group). The mRNA expressions of RRM1,-Tubb3 and ERCC1 in paraffin-embedded tissue sample from the test group were detected using fluorescence quantitative-HRM method,the patients from the test group were treated with GP,NP,TP or cis-platinum combined with Pemetrexed chemotherapy regimens according to their RRM1 and -Tubb3 expressions levels,respectively. The control group were treated with a random chemotherapy regimen. The chemotherapeutic effects and overall survival of two groups were observed. Results: The objective response rates in test group and control group were 66. 1% and 31. 7%,respectively. The disease control rates in two groups were 79. 7% and 46. 3%,the difference of which was statistical significance( P 0. 01). The overall survival in two groups were 11. 2 months and 9. 8 months,the difference of which had no statistical significance( P 0. 05). The objective response rate in test group treated with GP program( 70. 7%) was significantly higher than that in the control group( 32. 6%)( P 0. 01),the objective response rate in test group treated with NP and TP program( 66. 7%) was significantly higher than that in the control group( 29. 5%)( P 0. 01). The objective response rates in test group with low and high ERCC1 expressions were78. 7% and 50. 9%,respectively,the difference of which had statistical significance( P 0. 01). The overall survival in test group with low and high ERCC1 expressions were 11. 4 months and 10. 9 months,respectively,the difference of which had no statistical significance( P 0. 05). Conclusions: The expression levels of RRM1 and -Tubb3 in patients with stage Ⅲb/Ⅳ NSCLC can guide the selecting of chemotherapy regimen,which can significantly increase the response rate.

       

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