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Yang, Choi, You, Kim, Oak, Jang, and Jung: Relation between ERCC1 Expression in Sputum and Survival after Cisplatin-Based Chemotherapy in Patients with Non-Small Cell Lung Cancer
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 60(2): 151-159.

Published online: 28 February 2006

DOI: https://doi.org/10.4046/trd.2006.60.2.151

Relation between ERCC1 Expression in Sputum and Survival after Cisplatin-Based Chemotherapy in Patients with Non-Small Cell Lung Cancer

Sung Woo Yang, M.D., Pyoung Rak Choi, M.D., Hong Jun You, M.D., Jin Gu Kim, M.D., Chul Ho Oak, M.D., Tae Won Jang, M.D., Maan Hong Jung, M.D.

Department of Internal Medicine, Kosin University, College of Medicine, Korea.

Address for correspondence: Maan Hong Jung, M.D., Department of Internal Medicine, Kosin University College of Medicine, 34 Amnam Dong, Suh Gu, Busan, 602-702, Korea. Phone: 82-51-990-6210, Fax: 82-51-248-5686, jungmh@ns.kosinmed.or.kr

Received 25 November 2005       Accepted 23 January 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Excision repair cross complementing gene 1 (ERCC1) not only has a protective role against carcinogens, but plays an important role in cisplatin-resistance via the repair of cisplatin-DNA adducts. This study investigated the association between the ERCC1 expression levels in sputum and survival after cisplatin-based chemotherapy in patients with inoperable non-small cell lung cancer (NSCLC).

Methods

Using the sputum collected from 67 inoperable (stage IIIa-IV) NSCLC patients treated with either taxanes (33 cases) or gemcitabine (34 cases) plus cisplatin, the relative expression levels of ERCC1 and the expression of the tumor specific antigen, MAGE, were examined by the quantitative RT-PCR and RT-PCR, respectively. The response and survival were compared with the relative level of ERCC1 or MAGE expression and the treatment modality.

Results

In the sputum, ERCC1 and MAGE was detected in 74.6% and 40.2% of patients, respectively. Using the median ERCC1 level, the patients were classified as having high or low ERCC1 expression. The median overall survival (MST) was significantly longer in patients with a high ERCC1 expression level than those with a low expression level (84 weeks vs. 44 weeks respectively, P=0.017). In the taxene-based treatment group, the MST was longer than the gemcitabine group (79 weeks vs. 47 weeks, respectively, P=0.03). The levels of ERCC1 were significantly higher in patients who were MAGE-positive (P=0.003). In the MAGE-negative patients, the MST was longer in the high ERCC1 group (103 weeks vs. 43 weeks, P=0.008), but not in the MAGE-positive patients (62 weeks vs. 44 weeks, P=0.348).

Conclusion

ERCC1 expression in the sputum can be a prognostic factor for survival after chemotherapy in patients with inoperable NSCLC.

Keywords: ERCC1, MAGE, Non-small cell lung cancer, Sputum

Figures and Tables

Figure 1
Kaplan-Meier survival curve of the patients according to sputum ERCC1 levels above and below the median ERCC1 level of 4.85(p=0.01).
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Figure 2
Kaplan-Meier survival curve for MAGE-negative patients with sputum ERCC1 levels above and below the median ERCC1 level of 4.85.(P=0.008)
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Table 1
Oligonucleotide primers used for RT-PCR
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Table 2
Patients characteristics
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*MAGE: melanoma antigen gene

Table 3
Comparison of dermogrphic and clinical parameters between two groups of patients accoring to ERCC1 level
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*The median ERCC1 expression level, relative to the expression of internal control GAPDH, was 4.85 × 10-3(values shown here without × 10-3, e.g., median 4.85) +CR: Complete response, PR: Partial response.

Table 4
Factors associated with overall survival
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*ERCC1 expression levels are categorized according to whether there was less than the ERCC1 median value of 4.85(low) or greater than the median(high)

Notes

This work was supported by Kosin University Research Grant.

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