The Clinical Study Of ERCC1and RRM1Expression Levels In Non-small-cell Lung Cancer

Background:lung cancer is the leading cause of death worldwide.there are1.2million new cases each year. Non-small cell lung cancer is the main pathological types of lung cancer, accounting for80percent.lung cancer in early stage has no obvious or only mild symptoms.When the patients go to a doctor after having obviously clinical symptoms, they have mostly already belonged to the later period so that clinical treatment are unsatisfactory. About65%-70%of the NSCLC is already in advanced when found, which losesn the opportunity to surgery and multi-disciplinary complex treatment.chemotherapy as an important component of the comprehensive treatment, is the primary means of treatment. However, due to heterogeneity among individual presence, patients with the same pathological type and stage of NSCLC have great differences in sensitivity to the standard chemotherapy,and more toxic side effects of chemtherapy for patients. The effective rate of chemotherapy is only20%-40%, the median survival is10months.Along with deep scientific research and continual development fo pharmacogenetics and pharmacogenomic, we can use the Individual chemotherapy plans for patients."tailor"chemotherapy is that we can use the most powerful chemotherapy drugs by genetic characters in Patients.we have realized the different expression of ERCC1and RRM1may be related to the efficacy of diferent chemotherapeutic agents and prognosis in NSCLC. So it is possible for predicting results of chemotherapeutic agents with those different markers. Our study contain77NSCLC patients, immunohistochemistry (IHC) method was used in the detection of ERCC1and RRM1,42of which also used the suspension biochip in the detection of ERCC1and RRMl,we aimed to tell the differences between IHC and suspension biochip with regard to the expression levels of biomarkers in42patients and the prognostic value of ERCC1and RRM1in all77patients. Material and Method77NSCLC patients were enrolled into the study from June2010to Sempetember2012. All patiens received no anti-tumor therapy before surgery, IHC were used to detect the expression level of ERCCland RRMl protein in all NSCLC patients. Among all patients,42also use the suspensiong biochip to the detection of ERCC1, RRM1mRNA levels.were detected by suspention biochip.Results:The expression level of ERCC1and RRM1in42NSCLC patients tested by ICH are as follows:ERCC1(-)30cases,(+)8cases,(++)3cases,(+++)1case. RRM1(-)7cases,(+)26cases,(++)4cases,(+++)5case. The expression level of ERCC1and RRM1mRNA in42NSCLC patients tested by suspension biochip are as follows:ERCC1low expression21case, less moderate expression18cases, more moderate expression2cases, high expression lease. RRM1low expression9case, less moderate expression23cases, more moderate expression4cases, high expression6case.The consistent rates of the ERCC1and RRM1expression levels tested by IHC and suspension biochip were52.3%(22/42) and76.2%(32/42), respectively. A significant correlationship was observed between IHC and suspension biochip in terms of the RRM1expression levels (r=0.778, P=0.01). No such correlationship was found in the ERCC1expression levels (r=0.277, P=0.076). IHC was used in the detectiong of ERCC1and RRM1expression levels in all77NSCLC patients. We found no difference in ERCC1/RRM1expression level with regarding to sex, age,smoking status,pathology type,TNM stage,lymphnode metastasis. On postoperative survival, the surval curve of ERCC1negative group is better than ERCC1positive group(x2=4.257, P=0.039), difference was found on progress free survival time between ERCC1negative and positive group (17.3m VS14.3m,p=0.011),while no significant difference was found on overall survival time between two teams (20.3mVS18.1m,p=0.205). the survival curve of RRM1positive group is better than RRMl negative group(x2=5.948, P=0.015), no difference was found on overall survival time and progress free survival time between RRM1positive and negative group (21.5m VS18.3m,p=0.059;16.8mVS15.8m, p=0.396)Conclusion:Section one 1.The expression levels of RRM1tested by the two methods exhibited good correlationship. The expression levels of the RRM1mRNA in the NSCLC tissues were consistent with RRM1protein expression.2.No significant correlationship was found in the expression levels of ERCC1tested by the two methods. The expression levels of the ERCC1mRNA in the NSCLC tissues were not always correlated with ERCC1protein expression.3.The simultaneous use of IHC and suspension biochip can increase the sensitivity and specificity of chemotherapy.Section two1. There was no difference in ERCC expression levels between ERCC1positive group and negative group with regarding to sex, age,smoking status,pathology type,TNM stage,lymphnode metastasis.2. There was no difference in RRM1expression levels between RRM1positive group and negative group with regarding to sex, age,smoking status,pathology type,TNM stage,lymphnode metastasis.3. The surval curve of ERCC1negative group is better than ERCC1positive group(x2=4.257, P=0.039), difference was found on progress free survival time between ERCC1negative and positive group (17.3mVS14.3m,p=0.011),no significant difference was found on overall survival time between ERCC1negative and positive group(20.3mVS18.1m,p=0.205).4. The survival curve of RRM1positive group is better than RRM1negative group(x2=5.948, P=0.015), no difference was found on overall survival time and progress free survival time between RRM1positive and negative group (21.5m VS18.3m,p=0.059;16.8mVS15.8m, p=0.396)5. ERCC1and RRM1are two prognostic factors in NSCLC patients.