The Correlation Analysis Between The Short-term Efficacy Of Postoperative Adjuvant Chemotherapy For Non-Small Cell Lung Cancer And Driver Gene EGFR、KRAS And Resistance Protein ERCC1、RRM1

Background: For the early stage of the Non-Small Cell Lung Cancer（NSCLC）patients（stage IB、II、IIIA patients）,4cycle postoperative adjuvant chemotherapy with two drugsbased on platinum has become the standard treatment, but five year of absolute survival benefitis only5%,and to further improve the response rate has been research focus. Recently, severalstudies showed that the mutation of EGFR and KRAS and the expression of ERCC1and RRM1related to prognosis in NSCLC patients who accept postoperative adjuvant chemotherapy, andis expected to become the biomarkers to select benefit groups.Objective: To detect the mutation of EGFR and KRAS and the expression of ERCC1and RRM1in lung cancer and study the relationship among the mutation or expression andthe short-term efficacy of postoperative adjuvant chemotherapy。Methods:68postoperative specimens obtained from the patients who accept radicalsurgical resection and GP regimen postoperative adjuvant chemotherapy，we detect themutation of EGFR and KRAS by polymerase chaine reaction (PCR) and sanger sequencingand the expression of ERCC1and RRM1by immunohistochemistry technique. combine withtheir clinicopathologic features and follow-up results,the main outcome were measuredincluded disease free survival rate and median time to progress. the data is analyzed bySPSS19.0, Kaplan-Meier method was used to draw the disease-free survival curve,Log-ranktime series analysis was used between different subgroups,COX proportional hazards modelwas used for the univariate and multivariate analyses.Results:1. The EGFR mutation rate was47.1%(32/68), the mutation status related to age andpathological types (P <0.05);the disease-free survival rate of EGFR positive patientsis better than the negative patients, but there is no statistically significant difference (P>0.05).2. The KRAS mutation rate was1.5%(1/68), it was detected in a male、smoking、 adenocarcinoma patient.3. The ERCC1expression positive rate was51.5%(35/68), there is no relationshipbetween ERCC1expression and gender, age, smoking history, pathological types. thedisease-free survival rate and the median time to progress of ERCC1negative patientsis superior to the positive patients, but there is no statistically significant difference (P>0.05).4. The RRM1expression positive rate was54.4%(37/68). there is no relationshipbetween ERCC1expression and gender, age, smoking history, pathological types. thedisease-free survival rate of RRM1negative patients is superior to the positivepatients, and there is statistically significant difference (P<0.05), it is also aindependent factor of the short-term efficacy.5. The rate of ERCC1and RRM1double negative was20.6%,single positive was50%，double positive was29.6%，the disease-free survival rate of single positive patients issuperior to double positive patients, and there is statistically significant difference (P<0.05)，it is also a independent factor of the short-term efficacy.Conclusions:1. In the early stage of NSCLC patients who accept GP regimen as postoperativeadjuvant chemotherapy，the disease-free survival rate of EGFR positive patients isbetter than the negative ones, but there is no statistically significant difference;2. This study only detect one case of KRAS mutation in a male、 smoking、adenocarcinoma patient. so it can’t be subgrouped by KRAS mutation status;3. In the early stage of NSCLC patients who accept GP regimen as postoperativeadjuvant chemotherapy，the disease-free survival rate and the median time to progressof ERCC1negative patients is superior to the positive patients, but there is nostatistically significant difference;4. In the early stage of NSCLC patients who accept GP regimen as postoperativeadjuvant chemotherapy，the disease-free survival rate of RRM1negative patients issuperior to the positive patients, and there is statistically significant difference;5. In the early stage of NSCLC patients who accept GP regimen as postoperativeadjuvant chemotherapy，the expressive status of RRM1is a independent factor for the short-term efficacy;6. In the early stage of NSCLC patients who accept GP regimen as postoperativeadjuvant chemotherapy，the disease-free survival rate of single positive patients issuperior to double positive patients, and there is statistically significant difference;7. In the early stage of NSCLC patients who accept GP regimen as postoperativeadjuvant chemotherapy，the expressive status of RRM1and ERCC1is a independentfactor of the short-term efficacy.