| Background and Objective:Gastric cancer is the second Cause of death in the world, only less than lung cancer. Number of gastric cancer patients is more than 40% all over the world. Even though radical gastrectomy,5-year survival rate did not exceed 50%, So adjuvant chemotherapy is the primary method of postoperative treatment. Cisplatin is often used for postoperative adjuvant chemotherapy in gastric cancer, the cytotoxicity of cisplatin is mainly platinum-DNA adduct formation, inhibiting DNA replication and transcription. DNA repair mechanisms of drug resistance to platinum chemotherapy 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 rapid repair Stagnated in G2 / M phase of DNA damage, leading to platinum-resistant in tumor cells. ERCC1 gene expression effect the efficacy and the survival in non-small cell lung cancer patients who was treated platinum-based adjuvant chemotherapy in ovarian cancer, cervical cancer, bladder cancer, colorectal cancer and other malignancies have also studied, but few reports the influence between ERCC1 and the survival in gastric cancer patients who was treated platinum chemotherapy. Current the relationship between ERCC1 expression and survival in gastric cancer patients who was treated chemotherapy is unclear. In this study, the clinical reality was detected between chemotherapy and ERCC1 protein expression in different types gastric cancer by Immunohistochemical. The correlation among ERCC1 protein expression ,clinical characteristics and survival of gastric cancer . Analysis among ERCC1 protein expression, efficacy and survival in gastric cancer patients who was treated with platinum chemotherapy, For Individualized treatment of gastric cancer offer the reference.Materials and Methods:Retrospective study, was collected from January 1 ,2002 to January 1, 2008 in the Second Affiliated Hospital of Dalian Medical University, clinical data and pathology paraffin blocks of 46 cases patients who were treated radical gastrectomy (including 16 cases of poorly differentiated gastric adenocarcinoma, 19 cases of Moderate differentiated adenocarcinoma and 11 cases gastric signet ring cell carcinoma),ERCC1protein was detected in gastric cancer by immunohistochemistry. ERCC1 expression in different tissue types of gastric cancer whether is or not the differences by Mann-Whitney U test. The differences between ERCC1 and different tissue type of gastric cancer by Chi-square and Spearman correlation analysis, Analyze the correlation among ERCC1 protein expression ,clinical characteristics and survival of gastric cancer . Survival analysis was by Kaplan-Meier method, ERCC1 protein expression and survival was analyzed in gastric cancer patients who was treated platinum-containing chemotherapy by SPSS17.0 software analysis, P <0.05 was statistically significant. Follow-up deadline is March 1, 2011.Results:Gastric cancer cells, ERCC1 localized in the nucleus. 46 cases of gastric cancer patients, ERCC1 expression was positive in 31 cases, the positive rate of 45.6%.There was not significantly different of ERCC1 expression among Moderate differentiated adenocarcinoma, poorly differentiated adenocarcinoma and signet ring cell carcinoma of three histological types of gastric cancer (P = 0.724). ERCC1 expression was not connection with sex, age, tumor size, tumor differentiation, depth of invasion, lymph node metastasis and TNM staging. Disease-free surviva of ERCC1 postive and negative patients , is respectively 26.2 months and 14.3 months, P = 0.313, the difference was not statistically significant. ERCC1 positive patients,median survival was respectively 37.3 months, 20.1 months in ERCC1 negative patients, P= 0.157, there is not significant difference. ERCC1 positive patients, Compared with patients was treated with platinum chemotherapy and was not treated with adjuvant chemotherapy, overall survival was respectively 28.3 months and 44.1 months, P = 0.903, no significant difference; ERCC1 negative patients, Compared with patients was treated with platinum chemotherapy and was not treated with adjuvant chemotherapy, overall survival was respectively 20.1months and17.4 months, P = 0.956, no significant difference. Conclusion:1. ERCC1 expression was not significant difference with gender, age, tumor size, tumor differentiation, depth of invasion, lymph node metastasis and TNM staging. ERCC1 expression was no significant difference in different histological types of gastric carcinoma.2.There is a trend that ERCC1 expression Positive was better than ERCC1 negative expression on survival.3. ERCC1 expression may not predict the survival of gastric cancer patients who was treated postoperative adjuvant chemotherapy with platinum. |
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