Relationship Of Expression Of ERCC1MRNA And DNA Ploidy In Locally Advanced Cervical Cancer Tissue To Curative Effect Of Neoadjuvant Chemotherapy

Background and ObjectiveAccording to the FIGO (2009) stage, locally advanced cervical cancer (LACC)generally includes the stage IB2--IVA cervical cancer. However, in a narrow sense itrefers to the early clinical cervical cancer tumor (stage IB2、IIA2, diameter≥4cm inmassive type)[1]. This kind of cervical cancer is prone to lymph node metastasis ordistant metastasis.Although the National Comprehensive Cancer Network (NCCN) ClinicalPractice Guidelines in Oncology has recommended a direct chemoradiotherapy as themain treatment for locally advanced cervical cancer, some complications frequentlyoccurred after radiotherapy (RT) which decreased the quality of patients’ life, such asyoung women had appeared vaginal dryness and poor flexibility, radioactive cystitisor proctitis, especially loss of ovarian function and endocrine dysfunction afterradiotherapy. As a result, most experts have claimed the surgery after neoadjuvantchemotherapy (NACT) as the major treatment strategies. It has been reported that theeffective rate of NACT totally can reach as high as98%to100%[2]. Although thepostoperative pathologic results showed that the effect was obvious in patients who had high susceptibility to NACT, some postoperative patients still existed manyindications of RT such as vascular infiltration deeply, lymph node metastasis and soon. While both RT and surgery can cause edema of lower extremity. Postoperative RTwould aggravate the formation of edema and appear severe rubber legs. It isrecommended that the patients who appear different degree of complication have tocarry out postoperative chemoradiotherapy. Therefore, the effective biomarkers usedto monitor the sensitivity of NACT are urgently needed.In order to formulate individualized treatment plan for patients and reduce theoccurrence of complications possibly, and provide theory basis for screening patientsof locally advanced cervical cancer who are suitable for NACT, in the current study,we performed immunohistochemical staining using cervical cancer tissue samplesand investigated the association of the expression of ERCC1(Excision repaircross—complementing group1) and DNA ploidy with the curative effect ofchemotherapy. Our results suggest that both ERCC1and DNA ploidy are very usefulbiomarkers for evaluating the sensitivity of NACT and can be used for assessinglocally advanced cervical cancer patients in clinics.Methods60patients of locally advanced cervical cancer were collected for2cycles ofneoadjuvant chemotherapy (scheme of HBP), and evaluated the curative effectionafter chemotherapy. At the same time,collected the biopsy specimens of the patientsbefore chemotherapy.Applied PCR combined with the fluorescence probe techniqueto analyze the expression of ERCC1in the carcinoma tissue beforechemotherapy.And adopted the DNA quantitative analysis technique to analyze theexpression of DNA ploidy before chemotherapy.Analyzed the relationship betweenthe expression of ERCC1,DNA ploidy and the neoadjuvant chemotherapy sensitivityof locally advanced cervical cancer according to statistics.Results33cases were effective in the60patients, and the effective rate was 55.0%(33/60).The expression of ERCC1gene of the invalid neoadjuvantchemotherapy group was significantly higher than that of the effective group,and thedifference was statistically significant（t=-8.736, p＜0.05）.There was a correlationbetween DNA ploidy and the curative effect of neoadjuvant chemotherapy（χ2=4.972，p＜0.05，γ=0.288）.The patients’ sensitivity was much higher who was DNA diploidexpresser.In addition,there was no relationship between ERCC1expression and DNAploidy（z=-1.922, p＞0.05）.Conclusions1.The sensitivity of neoadjuvant chemotherapy for locally advanced cervical cancer isclosely associated with the expression of ERCC1, DNA ploidy. That is thechemotherapy sensitivity of ERCC1gene high expression is low, and which of DNAdiploid expresser is higher.2.ERCC1gene and DNA ploidy may be used as a prediction index of neoadjuvantchemotherapy sensitivity for locally advanced cervical cancer, but there was nocorrelation between them.