Abstract
Objective Excision repair cross-complementing gene-1(ERCC1) are key regulatory enzymes whose expression patterns are associated with overall survival(OS) in several malignancies.Their expression patterns and prognostic value in resected gastric adenocarcinoma(GAC) are not known and need to investigate. Methods A total of 109 patients who underwent resection for GAC in Liu′an People′s Hospital from January 2010 to June 2013 had tissue available for analysis.The primary objective was to assess for the differential expression of ERCC1 using by immunohistochemistry.The secondary objective was to assess for the association between OS and the expression of ERCC1. Results The median follow-up was 21.2 months, and the median OS was 28.8 months.Resected GAC exhibited differential expression of ERCC1(high expression, n=25(23%)). ERCC1 expression was not associated with OS(18.9 months vs.27.7 months, P=0.72). In a subset analysis of patients who received chemotherapy(n=73), high ERCC1 expression was associated with decreased OS(16.7 months vs.53.8 months, P=0.03). After controlling for known adverse pathologic features, high ERCC1 expression persisted as a negative prognostic factor in multivariate Cox regression analysis(HR=2.22, 95% CI1.05-4.98, P<0.05). Conversely, in patients who underwent resection only(n=35), high ERCC1 expression demonstrated a trend toward improved OS(40.4 months vs.12.7 months, P=0.10). A positive prognostic influence also was present on multivariate analysis(HR=0.20, 95% CI0.05-0.84, P=0.03). Conclusion Resected GAC exhibited differential expression of ERCC1.Among all patients, ERCC1 expression levels were not associated with OS.High ERCC1 tumor expression is associated with decreased OS in the patients who received chemotherapy but is associated with increased OS in those who underwent surgery alone.ERCC1 expression have prognostic value in resected gastric cancer, and further investigation is needed. Key words: Gastric adenocarcinoma; Excision repair cross-complementing gene-1; Biomarkers
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