Abstract:
Abstract Objective: To retrospectively analyze the expression of excision repair cross-complementation group 1 ( ERCC1 ) and β-tubulin Ⅲ in completely resected stage ⅢA-N2 non-small-cell lung cancer ( NSCLC ) and to examine the association between the molecular markers and response to the adjuvant chemotherapy to verify whether these markers are useful in selecting patients for adjuvant chemotherapy. Methods: Immunohistochemical analysis was used to determine the expression of ERCC1 and β-tubulin Ⅲproteins in resected stage ⅢA-N2 NSCLC specimens. The correlation among marker expression and the clinicopathologic factors and prognoses were analyzed. All analyses were performed using SPSS ( 16.0 ). Results: Among the 89 tumor patients, the positive expression rates of ERCC1 and β-tubulin Ⅲ were 46.1% and 53.9%, respectively. Platinum-based adjuvant chemotherapy significantly prolonged the disease-free survival ( DFS ) ( P = 0.000 ) and overall survival ( OS ) ( P = 0.000 ) in the tumor patients with negative expression of ERCC1. Paclitaxel ( Taxol ) significantly extended the DFS ( P = 0.003 ) and OS ( P = 0.004 ) in the patients with negative β-tubulin Ⅲ expression. Platinum + paclitaxel ( Taxol ) adjuvant chemotherapy significantly prolonged the DFS ( P = 0.000 ) and OS ( P = 0.001 ) in ERCC1-negative and β-tubulin Ⅲ-negative patients. Conclusion: ERCC1-positive expression, poorly differentiated or undifferentiated histologic grade, and pneumonectomy are independent prognostic factors for NSCLC. ERCC1 expression is associated with platinum-based regimens, and that of β-tubulinⅢ is related to tubulin-binding agents. Low expression of these markers indicates better outcomes. After administration of adjuvant chemotherapy with a platinum plus paclitaxel (Taxol) regimen, the prognosis was satisfactory both in the ERCC1-negative and in the β-tubulin Ⅲ-negative patients.