非小細胞肺癌–腺癌中切除修復交叉互補-1蛋白和胸苷酸合酶表現及表皮生長因子受體突變狀態的預後評估

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學研究所 > 博碩士論文 > Item 310902500/19659

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题名:	非小細胞肺癌–腺癌中切除修復交叉互補-1蛋白和胸苷酸合酶表現及表皮生長因子受體突變狀態的預後評估 Evaluating the Prognostic Value of ERCC1 and Thymidylate Synthase Expression and the Epidermal Growth Factor Receptor Mutation Status in Adenocarcinoma Non-Small-Cell Lung Cancer
作者:	林昌生 Lin, Chang-Sheng
贡献者:	中山醫學大學:醫學研究所;李孟智;楊順發
关键词:	非小細胞肺癌;表皮生長因子受體突變;切除修復交叉互補-1表現;胸苷;酸合酶;蛋白表現;酪氨酸激酶;抑製劑;化療 non-small-cell lung cancer;EGFR mutation status;ERCC1 expression;TS protein expression;tyrosine-kinase inhibitor;chemotherapy
日期:	2018
上传时间:	2019-01-04T04:43:55Z (UTC)
摘要:	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.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/19659
显示于类别:	[醫學研究所] 博碩士論文

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