ERCC1、RRM1和TUBB3指导个体化化疗方案治疗晚期非小细胞肺癌的评价

Evaluation of individualized chemotherapy for advanced non-small cell lung cancer guided by ERCC1，RRM1 and TUBB3

摘要:

目的：探讨切除修复交叉互补基因1（excision repair cross complement group1，ERCC1）、核糖核苷酸还原酶M1亚基（ri－bonucleotide reduc tase，RRM1）、3型β微管蛋白（tubulin beta-3，TUBB3）指导化疗药物个休化选择在晚期非小细胞肺癌（non-mall cell lung cancer，NSCLC）患者的疗效和安全性。方法：47例晚期NSCLC患者，按病理组织充足与否分个体化化疗治疗组（A组）及对照组（B组）。A组采用分支DNA-液相芯片技术测定ERCC1、RRM1及TUBB3的mRNA水平，并根据测定结果确定化疗方案，B组则使用吉西他滨+顺铂治疗。结果：A组有效率为63.2%，明显高于B组（P＜0.05）；A组、B组疾病控制率分别为78.9％ 和50.0％（P＜0.05）；A组中吉西他滨+顺铂患者的有效率高于B组相同方案化疗者；２组生活质量均较治疗前明显提高（P＜0.05），但2组改善率无显著差别（P ＞0.05）；2组不良反应无差异且均易耐受。结论：分支DNA-液相芯片技术测定ERCC1、RRM1及TUBB3的mRNA水平用于指导晚期NSCLC个体化化疗方案，能显著提高化疗有效率；吉西他滨+顺铂方案在分子标志物指导策略下运用效果更明显，但仍需进一步探索更有效的个体化治疗方案。

Abstract:

Objective：To explore the efficacy and safety of individualized selection of chemotherapy drug guided by excision repair cross complement group1（ERCC1），ribonucleotide reduc tase 1（RRM1） and tubulin beta 3（TUBB3） in patients with advanced non-small cell lung cancer（NSCLC）. Methods：Totally 47 cases of advanced NSCLC were divided into individualized chemotherapy treat－ment group（group A） and control group（group B） according to histopathological tissue sufficient or not. In group A，mRNA levels of ERCC1，RRM1 and TUBB3 were measured by branched DNA-liquid chip technique and chemotherapy regimen was formulated ac－cording to the measured results. Group B were treated by gemcitabine plus cisplatin. Results：Effective rate of group A was 63.2%，significantly higher than that of group B（P<0.05）. Disease control rates of group A and group B were 78.9% and 50.0% respectively（P<0.05）. Effective rate was significantly higher in patients treated by gemcitabine plus cisplatin in group A than in patients received the same treatment in group B. Quality of life in both groups was improved significantly after treatment（P<0.05） than before treat－ment，but there was no significant difference in improvement rate（P >0.05）. There was no difference in adverse reactions between both groups and all patients were well tolerated. Conclusions：Determination of mRNA levels of ERCC1，RRM1 and TUBB3 by branched DNA-liquid chip technique can guide individualized chemotherapy for advanced NSCLC and significantly improve chemotherapy efficiency； however，further exploration of more effective individualized treatment plan is needed.