非小細(xì)胞肺癌病人外周血淋巴細(xì)胞ERCC1 mRNA水平與鉑類藥物治療反應(yīng)的相關(guān)性

非小細(xì)胞肺癌病人外周血淋巴細(xì)胞ERCC1mRNA水平與鉑類藥物治療反應(yīng)的相關(guān)性摘要

目的：探討非小細(xì)胞肺癌病人外周血淋巴細(xì)胞ERCC1mRNA水平與鉑類藥物治療反應(yīng)的相關(guān)性。

方法：選取2017年1月至2021年12月在我院治療的非小細(xì)胞肺癌病人80例，按照治療方案分為鉑類藥物治療組（40例）和非鉑類藥物治療組（40例）。收集病人外周血樣本，采用RT-qPCR檢測(cè)外周血淋巴細(xì)胞中ERCC1mRNA水平，并分析其與治療反應(yīng)的關(guān)系。

結(jié)果：鉑類藥物治療組治療總有效率為55.0%，非鉑類藥物治療組治療總有效率為40.0%，兩組治療總有效率差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；鉑類藥物治療組ERCC1mRNA水平低于非鉑類藥物治療組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；鉑類藥物治療組ERCC1mRNA水平與治療反應(yīng)呈負(fù)相關(guān)，而非鉑類藥物治療組無(wú)明顯相關(guān)性。

結(jié)論：非小細(xì)胞肺癌病人外周血淋巴細(xì)胞ERCC1mRNA水平可以作為鉑類藥物治療反應(yīng)的預(yù)測(cè)指標(biāo)，為個(gè)體化治療提供參考。

關(guān)鍵詞：非小細(xì)胞肺癌；外周血淋巴細(xì)胞；ERCC1mRNA水平；鉑類藥物治療反應(yīng)；預(yù)測(cè)指標(biāo)

Abstract

Objective:ToinvestigatethecorrelationbetweenERCC1mRNAlevelsinperipheralbloodlymphocytesandplatinum-basedchemotherapyresponseinnon-smallcelllungcancerpatients.

Methods:Eightynon-smallcelllungcancerpatientstreatedinourhospitalfromJanuary2017toDecember2021wereselectedanddividedintoaplatinum-basedchemotherapygroup(40cases)andanon-platinum-basedchemotherapygroup(40cases)accordingtothetreatmentplan.Peripheralbloodsampleswerecollected,andERCC1mRNAlevelsinperipheralbloodlymphocytesweredetectedusingRT-qPCR,andtherelationshipbetweenERCC1mRNAlevelsandtreatmentresponsewasanalyzed.

Results:Thetotaleffectiverateoftheplatinum-basedchemotherapygroupwas55.0%,andthatofthenon-platinum-basedchemotherapygroupwas40.0%,withastatisticallysignificantdifferencebetweenthetwogroups(P<0.05);ERCC1mRNAlevelsintheplatinum-basedchemotherapygroupwerelowerthanthoseinthenon-platinum-basedchemotherapygroup,withastatisticallysignificantdifferencebetweenthetwogroups(P<0.05);ERCC1mRNAlevelsintheplatinum-basedchemotherapygroupwerenegativelycorrelatedwithtreatmentresponse,whiletherewasnosignificantcorrelationinthenon-platinum-basedchemotherapygroup.

Conclusion:ERCC1mRNAlevelsinperipheralbloodlymphocytesofnon-smallcelllungcancerpatientscanbeusedasapredictiveindicatorofplatinum-basedchemotherapyresponse,providingareferenceforindividualizedtreatment.

Keywords:Non-smallcelllungcancer;Peripheralbloodlymphocytes;ERCC1mRNAlevels;Platinum-basedchemotherapyresponse;PredictiveindicatorsNon-smallcelllungcancer(NSCLC)isaleadingcauseofcancer-relateddeathsworldwide.Platinum-basedchemotherapyisacommonlyusedtreatmentoptionforNSCLCpatients,buttheresponsetothistreatmentvariesamongindividuals.Therefore,thereisaneedforpredictiveindicatorstoidentifypatientswhoarelikelytorespondtoplatinum-basedchemotherapy.

Inthisstudy,theresearchersmeasuredthemRNAlevelsofERCC1(excisionrepaircross-complementationgroup1)inperipheralbloodlymphocytesofNSCLCpatientsbeforetreatmentwithplatinum-basedchemotherapy.TheyfoundthattheERCC1mRNAlevelsweresignificantlylowerinpatientswhorespondedtoplatinum-basedchemotherapythaninthosewhodidnotrespond.

Importantly,thecorrelationbetweenERCC1mRNAlevelsandtreatmentresponsewasonlysignificantintheplatinum-basedchemotherapygroup,butnotinthenon-platinum-basedchemotherapygroup.ThissuggeststhatERCC1mRNAlevelsarespecificallypredictiveofplatinum-basedchemotherapyresponseinNSCLCpatients.

ThefindingsofthisstudyhaveimportantimplicationsfortheuseofpersonalizedmedicineinthetreatmentofNSCLC.BymeasuringtheERCC1mRNAlevelsinperipheralbloodlymphocytes,clinicianscanidentifypatientswhoarelikelytorespondtoplatinum-basedchemotherapy,andthusselectthemostappropriatetreatmentoptionforeachindividual.ThiscanimprovetreatmentoutcomesandreduceunnecessaryexposuretotoxicchemotherapydrugsforpatientswhoareunlikelytobenefitfromthemInadditiontoitsimplicationsforpersonalizedmedicine,thisstudyalsohighlightsthepotentialuseofnon-invasivebiomarkersincancerdiagnosisandtreatment.Blood-basedbiomarkers,suchascirculatingtumorDNAandRNA,havebeenincreasinglystudiedasameansofdetectingandmonitoringcancer,predictingtreatmentresponseandprognosis,andguidingtreatmentdecision-making.Asdemonstratedbythisstudy,blood-basedbiomarkerscanprovidevaluableinformationaboutthemolecularcharacteristicsofapatient'stumorandtheirlikelihoodofrespondingtocertaintreatments,withouttheneedforinvasiveproceduressuchasbiopsies.

Moreover,theuseofblood-basedbiomarkerscouldalsoenablemorefrequentmonitoringofapatient'scancerstatusandtreatmentresponse,whichcouldleadtoearlierdetectionofdiseaseprogressionortreatmentfailure,andpromptadjustmentstotreatmentplans.Thisapproachwouldbeespeciallybeneficialforpatientswithadvancedormetastaticcancer,whorequireongoingmonitoringandoftenundergomultiplelinesoftreatment.

However,theuseofblood-basedbiomarkersincancerdiagnosisandtreatmentisstillintheearlystagesofdevelopment,andmoreresearchisneededtoestablishtheiraccuracy,reliability,andclinicalutility.Additionally,thecostandaccessibilityofthesetestsmayposechallengestotheirwidespreadadoptioninclinicalpractice.

Overall,thefindingsofthisstudyhighlightthepotentialofnon-invasivebiomarkers,suchasERCC1mRNAlevelsinperipheralbloodlymphocytes,asameansofpersonalizingcancertreatmentandimprovingtreatmentoutcomes.Continuedresearchanddevelopmentofblood-basedbiomarkerscouldhaveimportantimplicationsforthefutureofcancerdiagnosis,treatment,andmonitoringInadditiontothepotentialbenefits,therearealsosomelimitationsandchallengesassociatedwithusingnon-invasivebiomarkersforcancertreatment.Oneofthemainchallengesistheheterogeneityofcancer.Differenttypesofcancerhavedifferentmolecularprofiles,makingitdifficulttoidentifyasinglebiomarkerthatcouldbeusedacrossallcancers.

Furthermore,geneticvariationswithinindividualscanaffecttheexpressionofbiomarkers,andenvironmentalfactorssuchasdietandlifestylecanalsoimpactbiomarkerlevels.Therefore,itisimportanttovalidatebiomarkersinlarge,diversepopulationstoensuretheiraccuracyandreliability.

Anotherchallengeisthecostandaccessibilityofbiomarkertesting.Whileblood-basedbiomarkersmaybelessinvasivethantissuebiopsies,theystillrequirespecializedequipmentandexpertisetoanalyze.Thiscouldlimittheiravailabilitytocertainpopulations,particularlyinlow-resourcesettings.

Moreover,thedevelopmentofbiomarkersrequiressignificantinvestmentinresearchanddevelopment,aswellasregulatoryapproval.Thiscanmakeitdifficultforsmallercompaniesoracademicinstitutionstobringnewbiomarkerstothemarket.

Despitethesechallenges,thepotentialbenefitsofnon-invasivebiomarkersforcancertreatmentaresignificant.Advancesintechnologyandresearchmethodsareimprovingtheaccuracyandreliabilityofbiomarkers,andcollaborationsbetweenacademia,industry,andregulatoryagenciesarehelpingtoacceleratethedevelopmentandvalidationofnewbiomarkers.

Inconclusion,non-invasivebiomarkers,suchasERCC1mRNAlevelsinperipheralbloodlymphocytes,havethepotentialtorevolutionizecancertreatmentbyallowingforpersonalized,targetedtherapies.Whiletherearechallengesassociate