الفهرس 
Title: The Predictive value of ERCC1, RRM1 and TS for MPM patients in National cancer institute, Cairo University
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Abstract
Purpose The relationship between ERCC1, RRM1 and thymidylate synthase (TS) expression and outcome in patients with malignant pleural mesothelioma (MPM) treated with either pemetrexed cisplatin or gemcitabine cisplatin was evaluated. Patients and methods Ninety one histologically confirmed patients with MPM treated with Pemetrexed and platinum (55 of 91) or gemcitabine and platinum (36 of 91) were considered. ERCC1, RRM1 and TS expression levels were evaluated by immunohistochemistry using the H-score. Results There was a positive association of ERCC1 expression with TS expression (p=0.005); 70% of patients with low TS had low ERCC1, and 68% of high TS was associated with high ERCC1.On the other hand, there was no relation between ERCC1 and RRM1 expression pattern (p 0.296). In platinum-treated patients (n 91), a significant correlation was found with low ERCC1 median H-score and longer time to progression (TTP;9.6 v 5.3 months;P 0.001) or overall survival(OS;18.1 v 9.1 months ;P 0.001). In pemetrexed platinum treated patients (n 55), a significant correlation between low TS protein expression and longer time to progression (TTP; 11.8 v 5.4 months; P .001) or overall survival (OS; 19.8 v 8.5 months; P <0.001) was found when patients were divided according to median H-score.In gemcitabine platinum treated patients, low RRM1 expression was associated with longer progression free survival (TTP; 10.6 v 3.8 months) and overall survival (OS; 20.6 v 8.6 months). At multivariate analysis; the independent factors significantly affecting OS were tumor stage (HR: 2.3; 95% CI: 1.1-4.9; p= 0.021) and ERCC1 (HR: 2.7; 95% CI: 1.7-4.3; p < 0.001)o treatment, longer PFS, and OS