| Objective: To evaluate the value of combined detection ofERCC1(Excision Repair Cross Complementing gene-1), TUBB3(β-Tubulin-Ⅲ),and TOPO Ⅱ α(Topoisomerase Ⅱ α) mRNA for individual chemotherapyprogram of advanced gastric cancer.Methods: Patients with advanced gastric cancer were randomly dividedinto two groups. The control group were treated with DCF regimen（Docetaxel+DDP+5-Fu）or ECF regimen（EPI+DDP+5-Fu），without genetesting. In experimental group, we used multiplex branched-DNA liquid chiptechnology to examine the mRNA expressions of ERCC1, TUBB3and TOPOⅡα in gastric carcinoma tissues. Patients with low expression of ERCC1andTUBB3mRNA were treated with DDP and Docetaxel, respectively, whilepatients with high expression of TOPO Ⅱ α were treated with EPI. Thechemotherapy regimens used in experiment group was composed with5-Fu andthe relatively sensitive drugs based on the test results. The responserate(RR),median time to progression(mTTP), median time to overall survival(mOS) and toxicity were observed.Results: In experimental group, the low-expression rate of ERCC1andTUBB3mRNA were54.3%（19/35） and51.4%（18/35）, while thehigh-expression rate of TOPOⅡα mRNA was42.9%（15/35）. RR in theexperimental group(66.7%) was higher than that of the control group(54.8%), but was not statistically significant (P=0.443). There was statistical significancein mTTP(8.0months versus6.6months; P=0.001) and mOS(12.5months versus9.6months; P=0.002) between the two groups. The incidence rate of adversereaction including grade III or IV hematological toxicity, gastrointestinalreactions, neurotoxicity, catarrh in the experimental group was significant lowerthan that of in the control group (P=0.017，0.009，0.012and0.041,respectively).Conclusion:1.Combined detection of the mRNA expression of ERCC1, TUBB3andTOPOⅡα has guidance value for individualized chemotherapy in advancedgastric cancer patients, which prolonged mTTP and mOS, improved theresponse rate, reduced the adverse reaction of chemotherapy, and improved thechemotherapy tolerance.2.The combined detection of the mRNA expression of ERCC1, TUBB3andTOPO Ⅱα has a certain degree of instructive significance and may be helpful forthe selection of clinical individualized chemotherapy in advanced gastric cancerpatients. |
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