title: Expression of excision repair cross-complementation group 1 protein predicts poor outcome in patients with small cell lung cancer.
abstract: BACKGROUND
  Alterations in apoptosis-related proteins and DNA damage repair proteins are associated with resistance to chemotherapy or radiotherapy, which is the most important cause of treatment failure in small cell lung cancer (SCLC).
  
  
  METHODS
  Pretreatment tumor biopsy specimens from 77 patients with SCLC (limited stage: 40, extensive stage: 37) were analyzed for p53, bcl-2, bax and ERCC1 expression by immunohistochemistry. All patients were treated with platinum-based doublets. The most commonly used regimen was etoposide/cisplatin (50 patients). In patients with limited stage SCLC, thoracic irradiation was performed either concurrently with chemotherapy or sequentially.
  
  
  RESULTS
  High expression of p53, bcl-2, bax and ERCC1 was observed in 40 (52%), 72 (94%), 38 (49%) and 13 (17%) patients, respectively. High expression of ERCC1 was associated with poor OS (1-year, 23% vs. 53%; p=0.026). When grouped according to stage, a significant correlation between high expression of ERCC1 and poor outcome was observed only in patients with limited stage SCLC (p=0.017). High expression of p53, bcl-2 and bax was not correlated with patient outcome. Multivariate analysis showed that extensive stage (p=0.006) and male gender (p=0.009) were independent predictors of poor OS, while high expression of ERCC1 failed to reach statistical significance despite a trend (p=0.057). In limited stage patients, high expression of ERCC1 was an independent prognostic factor for poor OS (p=0.046), along with male gender (p=0.033).
  
  
  CONCLUSIONS
  High expression of ERCC1 protein may be a useful predictor of poor outcome in SCLC patients treated with chemotherapy with or without radiotherapy, especially in limited stage SCLC.
authors: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon 443-721, Republic of Korea.
authors: Hyun Woo
authors: HW
authors: Lee
authors: Jae Ho
authors: JH
authors: Han
authors: Jang Hee
authors: JH
authors: Kim
authors: Myoung Hee
authors: MH
authors: Lee
authors: Seong Hyun
authors: SH
authors: Jeong
authors: Seok Yun
authors: SY
authors: Kang
authors: Jin-Hyuk
authors: JH
authors: Choi
authors: Young Taek
authors: YT
authors: Oh
authors: Kwang Joo
authors: KJ
authors: Park
authors: Sung Chul
authors: SC
authors: Hwang
authors: Seung Soo
authors: SS
authors: Sheen
authors: Ho-Yeong
authors: HY
authors: Lim
mesh_terms: D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000737:chemistry* / Q000401:mortality; D004268:DNA-Binding Proteins / Q000032:analysis*; D004720:Endonucleases / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000737:chemistry* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D051028:bcl-2-Associated X Protein / Q000032:analysis
chemical_list: D004268:DNA-Binding Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53; D051028:bcl-2-Associated X Protein; C071447:ERCC1 protein, human; D004720:Endonucleases