Abstract
BackgroundThe purpose of this study was to investigate whether the excision repair cross-complementation group 1 (ERCC1) mRNA expression could predict treatment response of patients with locally advanced cervical squamous cell carcinoma (LACSCC) who underwent cisplatin-based concurrent chemoradiotherapy (CCCRT).MethodsA total of sixty LACSCC patients, treated with radical CCCRT from a single institution were evaluated. ERCC1 mRNA expression was determined by quantitative real-time RT-PCR in pre-treatment tumor tissues. The association of ERCC1 status with clinicopathological characteristics (age, histological grade, tumor size, parametrial invasion, lymph node metastasis and FIGO stage) and treatment response were analyzed.ResultsNo significant association between ERCC1 mRNA expression and clinicopathological characteristics were observed. Patients with low ERCC1 mRNA level had a significantly higher rate of complete response (86.21%) than patients with high level of ERCC1 expression (19.36%; p < 0.001). In the logistic regression analysis, low ERCC1 mRNA level retained an independent role in predicting complete response to CCCRT (P < 0.001). An ERCC1 expression level of 0.0901 was determined as an optimal cutoff value to identify complete response patients to CCCRT treatment. The sensitivity for detection of a complete response was 81.48% with a specificity of 96.97% (area under the curve, 0.893; 95% confidence interval, 0.804–0.983).ConclusionsThis is the first analysis of the association between ERCC1 mRNA levels and treatment response in patients with LACSCC. Low ERCC1 mRNA level appears to be a highly specific predictor of response to CCCRT in LACSCC.
Highlights
The purpose of this study was to investigate whether the excision repair cross-complementation group 1 (ERCC1) mRNA expression could predict treatment response of patients with locally advanced cervical squamous cell carcinoma (LACSCC) who underwent cisplatin-based concurrent chemoradiotherapy (CCCRT)
In the logistic regression analysis, only low ERCC1 mRNA level retained an independent role in predicting complete response to CCCRT (Table 2)
Several preclinical and clinical studies have investigated the expression of ERCC1 mRNA and protein in multiple cancer types and have demonstrated a correlation between the ERCC1 expression levels and the treatment response to platinum-based therapy and/or survival outcome [3,4,5,6,7,8,9,10]. These results suggest that ERCC1 expression may assist in selecting patients most likely to benefit from platinum agent-based chemotherapy or chemoradiotherapy
Summary
The purpose of this study was to investigate whether the excision repair cross-complementation group 1 (ERCC1) mRNA expression could predict treatment response of patients with locally advanced cervical squamous cell carcinoma (LACSCC) who underwent cisplatin-based concurrent chemoradiotherapy (CCCRT). The current standard treatment of locally advanced cervical cancer is cisplatin-based concurrent chemoradiotherapy (CCCRT), followed by brachytherapy [1]. Earlier in vitro studies have linked cisplatin resistance to the expression of ERCC1 mRNA in cell lines of cervical cancers [11]. The association of ERCC1 and treatment response in clinical setting, especially for cervical squamous cell carcinoma, has not be well documented. The purpose of present study was to evaluate whether the ERCC1 mRNA expression levels could predict the treatment response of patients with locally advanced cervical squamous cell carcinoma (LACSCC) who underwent CCCRT
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