Application Of ERCC1 Expression In Circulating Tumor Cells In The Treatment And Prognosis Of Ovarian Cancer

In recent years, circulating tumor cell(CTC) has been widely studied, and it is pointed out that CTC is associated with recurrence and metastasis of malignant tumors. The excision repair cross-complementation gene 1 (ERCCl) is thought to forecast platinum chemosensitivity. The expression of ERCC1 in CTC may be of the clinical value in the treatment and prognosis of epithelial ovarian carcer (EOC).Objective1. To explore the relationship between the expression and distribution of ERCC1 in CTC and the clinical characteristics of epithelial ovarian cancer.2. To observe the expression of ERCC1 in different types of CTC in patients with EOC.3. To observe the different expression level of ERCC1 in CTC in patients with EOC.4. To study the relationship between the expression of ERCC1 and the chemosensitivity of platinum in patients with EOC.Methods1 . The study is divided into two parts。The first part: a total of 20 patients with EOC in Chinese People’s Liberation Army General Hospital from March 2015 to December 2016 were enrolled in this study. ERCC1 expression in CTC and CTC was measured by 5ml peripheral blood in one week after operation.The second part: a total of 13 patients with EOC in Chinese People’s Liberation Army General Hospital from March 2015 to May 2016 were enrolled in this study, and all patients were followed up for 6 months after treatment. ERCC1 expression in CTC and CTC was measured by 5ml peripheral blood which was collected at three time points during postoperative chemotherapy.2. The detection technology of CTC and ERCC1 expression in CTC The second generation technique of CanpatrolTM CTC was used to CTC and ERCC1 expression in CTC. Immune beads were first used to remove leukocytes from 5ml peripheral blood,and then CTC was filtered out with nanofiltration membrane. CTC was genotyped by fluorescence in situ hybridization (FISH), and ERCC1 gene was labeled with multiple mRNA in situ analysis.3. ERCC1-positive CTC was expressed using ERCC1+CTC; ERCC1-negative CTC was expressed using ERCC1-CTC.Results1. ERCC1+CTCs of patient with ascites were significantly higher than those without ascites (P <0.05).2. The positive expression of ERCC1 in the E-M mixed CTCs was significantly higher than that in Msenchymal cells (P <0.05). The more expression of ERCC1 in the E-M mixed CTCs were detected in patients with platinum-sensitive and platinum-resistant(T1-T3).3. The number of CTC with H-ERCC1 was significantly decreased than that with M-ERCC1 or L-ERCC1(P<0.05). The number of ERCC1-CTC in platinum-sensitive group was significantly higher than that in platinum-resistant group (P <0.05).4. The number of ERCC1+CTC in platinum-sensitive patients showed a decreasing trend, while in platinum-resistant group became stable and increased. The positive expression of ERCC1 in the Msenchymal CTCs in platinum-resistant group was significantly higher than that in platinum-sensitive group at T1、T2、T3 point time (P<0.05). The number of ERCC1+CTCs in platinum-resistant group was significantly higher than that in platinum-sensitive group at T3 point time (P <0.05). The positive expression of ERCC1 in the E-M mixed CTCs and the number of CTC with L-ERCC1 in platinum-resistant group was higher than that in platinum-sensitive group at T3 point time(P <0.05).Conclusion1. The EOC patient with ascites has a high ERCC1 positive rate in CTC.2. The expression of ERCC1 in CTC can predict the sensitivity of platinum chemotherapy in patients with ovarian cancer. The more expression of ERCC1 in CTC were detected in patients with platinum-resistant.3. The positive expression of ERCC1 in the Msenchymal CTC and the number of CTC with L-ERCC1 may suggest platinum-resistant in patients with EOC.In conclusion, the expression of ERCC1 in CTC can be used as an effective index to evaluate the chemotherapy effect and prognosis of patients with EOC, and it is also to guide individual therapy.