| PurposeBy analyzing the relationship of ERCC1 protein which expresses in tissue of gastric cancer patients of Ⅱ,Ⅲ stage after D2 radical surgery with survival,and to explore the effects of ERCC1 protein expression on the prognosis of patients with gastric cancer.Meanwhile,by studying the impact on the long-term survival of fluorouracil plus platinum-based chemotherapy on the different protein status of Ⅱ,Ⅲstage gastric cancer patients,and to explore whether ERCC1 protein is expressed in predicting benefit from adjuvant chemotherapy significance,a reference for the selection and application of clinical chemotherapy drugs should be provided.Methods1.From January 2006 to December 2008,395 patients who underwent radical surgery in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.Postoperative adjuvant chemotherapy was composed of platinum combined with fluorouracil.Inquiries by telephone or hospital medical records of these patients were followed up.2.ERCC1 expression in resected samples obtained from patients with stage ⅡorⅢ gastric cancer was determined by immunohistochemistry(IHC).3.The correlation between ERCC1 expression and patients’ survival was analyzed by SPSS 25.0 statistical software.Factors influencing patients’ survival were analyzed by using univariate and multivariate analysis.Results1.Among 395 patients,253(64.0%)was positive in ERCC1 expression.No correlation was found between ERCC1 expression and gender,age,tumor size,histological grade,depth of invasion,blood vessel and perineural invasion,lymph node metastasis,or TNM stage(P > 0.05).2.The median survival time of 395 patients was 28.13 months and the 5-year overall survival rate was 28.60%.The median survival time of ERCC1-positive group was 28.50 months and ERCC1-negative group was 26.27 months.No significant difference was found between these two group(P = 0.712).Among patients who did not receive adjuvant chemotherapy,the median survival time of ERCC1-positive group was 28.46 months and ERCC1-negative group was 18.10 months,there was no significant difference(P = 0.139).Also,among patients who received adjuvant chemotherapy,there was no significant difference between ERCC1-positive group and ERCC1-negative group(MST 30.87 months versus 30.87 months,P = 0.700).In ERCC1-negative group,the median survival time of those who underwent chemotherapy was longer than that of those without chemotherapy(MST 30.87 months versus 18.10 months,P = 0.007).In ERCC1-positive group,the median survival time of those who received chemotherapy was 28.50 months and those without chemotherapy was 28.47 months(P = 0.332).3.By a multivariate analysis,it was indicated that those factors such as tumor size,depth of invasion,number of metastatic lymph nodes,and chemotherapy were significantly independent in the prognosis of gastric cancer(P < 0.05).Conclusions1.Receiving adjuvant chemotherapy can significantly prolong the overall survival time of patients with stage Ⅱ-III gastric cancer after radical resection.2.For patients underwent postoperative adjuvant chemotherapy,the expression of protein ERCC1 may influence the efficacy of platinum drugs thus affecting the survival of patients.Patients with negative expression of the proteins in may benefit from adjuvant chemotherapy in platinum plus fluorouracil,while the patients with expressions cannot benefit from chemotherapy.3.The positive expression of ERCC1 may be a good prognostic index.4.All those factors,including tumor size,depth of invasion,number of metastatic lymph nodes and chemotherapy,have been demonstrated as independent prognostic elements involved in the prognosis of gastric cancer. |
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