RESUMEN
Excision repair cross-complementing gene-1 (ERCC1) is a key regulatory enzyme whose expression patterns in tumor tissues are associated with survival in gastric cancer. The present study aimed to evaluate the effects of ERCC1 expression in peripheral blood lymphocytes (PBLs) on the outcome of patients with gastric cancer treated with oxaliplatin-based adjuvant chemotherapy. Tumor and PBL samples from 48 patients treated with adjuvant oxaliplatin-based chemotherapy for gastric cancer were analyzed. Immunohistochemistry was used to assess the expression of ERCC1. After a median follow-up of 18.5 months, the median disease-free survival (DFS) and overall survival (OS) were 12 and 20 months, respectively. Expression of ERCC1 was found in 72.9% (35/48), 56.3% (27/48), and 10.0% (2/20) of tumor tissues, PBLs from gastric cancer patients, and PBLs from controls, respectively. A significant positive correlation between ERCC1 expression in PBL and cancer tissue was found (χ(2) = 12.098, P = 0.001, Pearson contingency coefficient = 0.502). Patients with negative expression of ERCC1 in tumor tissues had a significantly longer median DFS and median OS compared to patients with positive expression of ERCC1 (median DFS, 18 vs 10 months, P = 0.006; median OS, 30 vs 17 months, P = 0.012). In PBLs, high expression of ERCC1 was associated with decreased DFS (9 vs 18 months, P = 0.032), but not OS (16 vs 24 months, P = 0.057). Patients with gastric cancer exhibiting negative expression of ERCC1 are more likely to benefit from oxaliplatin-based adjuvant chemotherapy.
Asunto(s)
Proteínas de Unión al ADN/metabolismo , Endonucleasas/metabolismo , Linfocitos/metabolismo , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/mortalidad , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Proteínas de Unión al ADN/genética , Endonucleasas/genética , Femenino , Estudios de Seguimiento , Expresión Génica , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Estadificación de Neoplasias , Compuestos Organoplatinos/administración & dosificación , Oxaliplatino , Pronóstico , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
The etiological factors, clinical characteristics, diagnosis, treatment strategies, and prognosis of multiple primary malignant neoplasms (MPMNs) were investigated in order to improve its diagnosis and therapy. Clinical data of 170 patients with MPMN who were admitted to the Oncology Department of the First Affiliated Hospital of Anhui Medical University from January 2004 to April 2010 were collected and analyzed retrospectively. The overall incidence of MPMNs was 2.25%. There were 167 cases with duplex primary cancers, 2 cases with triple primary cancers, 1 case with quadruple primary cancer, 46 synchronous MPMNs (SMPMNs), and 124 metachronous MPMNs (MMPMNs). There were 344 malignant neoplasms in the 170 MPMN patients, of which 161 were in the alimentary system, 48 in the respiratory system, 63 in mammary glands, 30 in the genital system, 7 in the urinary system, 23 in the head and neck, and the other 12 were in the brain, hematological system, and soft tissue. There were 22 cases of bilateral primary breast cancer and 41 cases of digestive MPMN. With a median survival time of 24 months, the 1-, 3-, and 5-year cumulative survival rates in the 170 patients were 68.8, 39.1, and 25.2%, respectively. The most common locations of MPMN were the alimentary system, mammary gland, and respiratory system. MPMN usually occurred in distinct organs of identical systems, conjugate organs, or identical organs. The survival rate of SMPMN was similar to that of MMPMN. There were differences in principles of treatment and diagnosis between MPMN and metastasis or recurrent cancers.