Chinese Clinical Oncology

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Combined analysis of protein expression of ERCC1 and RRM1 to predict prognosis and curative effect in patients with locally advanced cervical cancer receiving nedaplatin-based concurrent chemoradiotherapy

FU Juan, ZHANG Aiyun, LUO Aihua, OU Baoquan, YIN Yifa.   

  1. Yichang Second People's Hospital, the Second People's Hospital of Three Gorges University
  • Received:2015-03-19 Revised:2015-04-07 Online:2015-05-31 Published:2015-05-31
  • Contact: YIN Yifa

Abstract: Objective To explore the protein expression of nucleotide excision repair cross complementing gene 1 (ERCC1) and ribonucleotide reductase subunit M1 (RRM1) and their roles in predicting prognosis and curative effect in patients with locally advanced cervical cancer receiving nedaplatinbased concurrent chemoradiotherapy (CCRT). Methods In a retrospective analysis, 72 patients with cervical cancer in our hospital from February 2009 to November 2012 receiving nedaplatin-based CCRT were enrolled. According to the effect of CCRT, the patients were assigned into sensitive group and resistance group. The protein expressions of ERCC1 and RRM1 were detected by immunohistochemistry method in the biopsy tissues before treatment. The impact of expression of proteins on the prognosis and therapeutic effect, and their correlations with clinicopathological features were investigated further. The predictive value of ERCC1 and RRM1 on the curative effect of nedaplatinbased CCRT was investigated by receiver operating characteristic curve (ROC) analysis. Results The RRM1 and ERCC1 expressions in carcinoma tissues were higher than those in paracarcinoma tissues (P<0.05). The 54.2% and 59.7% of patients with tumors had high expressions of ERCC1 and RRM1, respectively. In sensitive group, the highexpression rates of ERCC1 and RRM1 were 42.9% and 47.6%, lower than 70.0% and 76.7% in resistance group with significant difference(P<0.05). The AUC, sensitivity and specificity of ERCC1 and RRM1 in predicting the curative effect of nedaplatin-based CCRT were 0.915 and 0.944, 92.1% and 87.3%, and 86.2% and 91.0%, respectively. Expression of ERCC1 was related with FIGO staging, differentiation and pelvic lymph node swelling, and expression of RRM1 was related with the degree of differentiation and pelvic lymph node swelling (P<0.05). The median progression free survival (PFS) of patients with high ERCC1 expression was 27.5 months, similar with the 286 months in patients with low ERCC1 expression. The median PFS was 200 months in patients with high RRM1 expression, lower than 37.5 months in patients with low RRM1 expression(P<0.05).
Conclusion There are higher expression levels of ERCC1 and RRM1 in cervical carcinoma tissues. Both the expression levels of two proteins are related with the curative effect, the degree of differentiation and pelvic lymph node swelling. Both levels of ERCC1 and RRM1 can be used for the prediction of curative effect in locally advanced cervical cancer receiving nedaplatinbased concurrent chemoradiotherapy.

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