研究背景
本研究評估表皮生長因子受體（EGFR）突變狀態和切除修復交叉互補-1（ERCC1）蛋白和胸苷酸合酶（TS）蛋白表現量對於非小細胞肺癌-腺癌（AC-NSCLC）患者以酪氨酸激?抑製劑（TK I）及鉑金併培美曲塞化學療法的接續治療（接續的二線治療）預後的重要性。
研究方法
總共納入了131例AC-NSCLC患者。透過直接DNA定序和免疫組織化學分析評估EGFR突變狀態和ERCC1及TS蛋白表現。
研究結果
EGFR突變狀態和ERCC1和TS蛋白表現是臨床預後的重要預測因子。EGFR突變狀態是總存活期（OS）優勢的主要預測因子。進一步的探討ERCC1和TS蛋白表現分析，以提供額外的理解。低TS蛋白表現量預測了陰性EGFR突變的晚期AC-NSCLC患者擁有較佳總存活期，而高ERCC1蛋白表現量導致陽性EGFR突變的晚期AC-NSCLC患者的總存活期較差。TS和ERCC1表現量分別為陰性和陽性EGFR突變AC-NSCLC的有效預後因子。
結論
總之，本研究結果闡明，接續的AC-NSCLC二線治療，EGFR突變狀態和TS和ERCC1蛋白表現量可作為總存活期的預測因子。
Background
The present study evaluated the prognostic value of the epidermal growth factor receptor (EGFR) mutation status, and excision repair cross-complementation group 1 (ERCC1) and thymidylate synthase (TS) expression following intercalated tyrosine kinase inhibitor (TKI) therapy and platinum- and pemetrexed-based chemotherapies (subsequent second-line treatment) for patients with adenocarcinoma non-small-cell lung cancer (AC-NSCLC).
Methods and Materials
In total, 131 patients with AC-NSCLC were enrolled. The EGFR mutation status and ERCC1 and TS expression were evaluated through direct DNA sequencing and immunohistochemical analyses, respectively.
Results
The EGFR mutation status and ERCC1 and TS expression were the significant predictors of clinical outcomes. The EGFR mutation status was the main outcome predictor for overall survival (OS) benefits in the overall population. Further exploratory ERCC1 and TS expression analyses were conducted to provide additional insights. Low TS expression was predictive of improved OS of patients with negative EGFR-mutated advanced AC-NSCLC, whereas high ERCC1 expression resulted in poor OS in patients with positive EGFR-mutated advanced AC-NSCLC. TS and ERCC1 expression levels were effective prognostic factors for negative and positive EGFR-mutated AC-NSCLC, respectively.
Conclusions
In conclusion, the present results indicate that the EGFR mutation status and TS and ERCC1 expression can be used as the predictors of OS after subsequent second-line treatments for AC-NSCLC.
