摘要目的 探讨核糖核苷酸还原酶M1 (RRM1)蛋白的表达水平与非小细胞肺癌(NSCLC)患者术后采用吉西他滨联合顺铂(GP方案)辅助化疗疗效的关系.方法 采用免疫组化法检测根治术后68例NSCLC患者肿瘤组织中RRM1蛋白的表达情况,分析其表达水平与NSCLC根治术后GP方案辅助化疗疗效的关系.结果 68例患者中,复发或转移31例.RRM1蛋白的表达率为54.4％.RRM1阴性组NSCLC患者的1、3年无病生存率分别为82.7％和61.5％,RRM1阳性组NSCLC患者的1、3年无病生存率分别为78.1％和36.8％,差异有统计学意义(P =0.044).ⅠB期患者中,RRM1阳性组患者的1、3年无病生存率分别为84.5％和24.6％,RRM1阴性组患者的1、3年无病生存率分别为100％和82.3％,差异有统计学意义(P=0.047).鳞癌患者中,RRM1阳性组患者的1、3年无病生存率分别为83.1％和43.9％,RRM1阴性组患者的1、3年无病生存率分别为92.3％和83.7％,差异有统计学意义(P=0.005).Cox多因素分析结果显示,吸烟史、病理类型、临床分期和RRM1表达情况与NSCLC患者的预后有关(均P＜0.05).结论 RRM1蛋白的表达与NSCLC患者术后GP方案辅助化疗的疗效有关,有助于筛选GP方案辅助化疗的获益人群.

abstractsObjective The purpose of this study was to investigate the relationship between the expression of ribenucleotide reductase subunit M1 (RRM1) protein and the efficacy of gemcitabine/cisplatin (GP) adjuvant chemotherapy in postoperative non-small cell lung cancer (NSCLC) patients.Methods A total of 68 patients with NSCLC after radical surgery were included in this study.The expression of RRM1 protein in tumor specimens was assayed by streptavidin-peroxidase (SP) immunohistochemistry retrospectively.Correlation between the expression of RRM1 protein and the efficacy of GP chemotherapy was analyzed.Disease-free survival rate was taken as the main outcome measure.Results Among the 68 patients,31 cases had recurrence or metastasis.The expression rate of RRM1 was 54.4％.The 1-year and 3-year disease-free survival rates were 82.7％ and 61.5％ for patients with RRM1-negative expression,and 78.1％ and 36.8％ for patients with RRM1-posivive expression,respectively (P =0.044).In the subgroup analysis of stage IB cases,the 1-year and 3-year disease-free survival rates were 100％ and 82.3％ for patients with RRM1-negative expression,and 84.5％ and 24.6％ for patients with RRM1-positive expression,respectively (P =0.047).In the analysis of squamous cell carcinoma subgroup,the 1-year and 3-year disease-free survival rates were 92.3％ and 83.7％ for patients with RRM1-negative expression,and 83.1％ and 43.9％ for patients with RRM1-posivive expression,respectively (P =0.005).Univariate analysis and multivariate analysis indicated that smoking history,pathological type,clinical stage and expression of RRM1 significantly influenced the therapeutic efficacy (P ＜ 0.05).Conclusions RRM1 protein may be a valuable predictive factor for gemcitabine/cisplatin adjuvant chemotherapy in NSCLC patients.