HER2和C反应蛋白/白蛋白比值对胃癌患者术后远期生存情况的影响  

The impact of HER2 and C-reactive protein/albumin ratio on the long-term survival of gastric cancer patients after surgery

作　　者：严礼平 龚伟[1] 江姜乐 华芬芬 曹淑艳 Yan Liping;Gong Wei;Jiang Jiangle;Hua Fenfen;Cao Shuyan(Department of Pathology,Lishui Central Hospital,Lishui 323000,China;Department of Pathology,Linfen People′s Hospital,Linfen 041000,China)

机构地区：[1]丽水市中心医院病理科,丽水323000 [2]临汾市人民医院病理科,临汾041000

出　　处：《中国医师杂志》2023年第10期1506-1510,共5页Journal of Chinese Physician

基　　金：浙江省医药卫生科技计划项目(2022KY42)

摘　　要：目的探讨人类表皮生长因子受体2(HER2)和C反应蛋白/白蛋白比值(CAR)对胃癌患者术后远期生存情况的影响。方法回顾性纳入2015年1月至2017年12月期间丽水市中心医院收治的136例胃癌患者作为研究对象,均接受根治性手术治疗,术后均随访5年,根据术后HER2免疫组化结果将患者分为HER2阳性组和HER2阴性组,根据CAR平均值将患者分为高CAR组和低CAR组。分析HER2和CAR与胃癌患者临床病理特征的关系,比较两组患者(HER2阳性组和HER2阴性组以及高CAR组和低CAR组)术后无瘤生存率和总生存率,Cox回归分析获得胃癌患者术后肿瘤复发转移和死亡的独立预测因素。结果HER2阳性组肿瘤长径、低未分化所占比例、T_(3-4)期肿瘤浸润深度所占比例、淋巴结转移率以及脉管侵犯率明显高于HER2阴性组(均P<0.05),高CAR组肿瘤长径、低未分化所占比例、T_(3-4)期肿瘤浸润深度所占比例、淋巴结转移率以及脉管侵犯率明显高于低CAR组(均P<0.05)。Kaplan-Meier生存分析显示,HER2阴性患者术后1年、3年、5年累积无瘤生存率和总生存率明显高于HER2阳性患者,低CAR组患者术后1年、3年、5年累积无瘤生存率和总生存率明显高于高CAR组患者(均P<0.05)。多因素Cox回归分析结果显示,T_(3-4)期肿瘤浸润深度、淋巴结转移、HER2阳性以及高CAR表达为胃癌患者术后肿瘤复发转移和死亡的独立预测因素(均P<0.05);其中HER2阳性胃癌患者术后肿瘤复发转移的风险是HER2阴性患者的1.895倍(HR:1.895,95%CI:1.245~4.229,P=0.034),高CAR组胃癌患者术后肿瘤复发转移的风险是低CAR组患者的1.769倍(HR:1.769,95%CI:1.433~3.959,P=0.039),HER2阳性胃癌患者术后死亡的风险是HER2阴性患者的2.145倍(HR:2.145,95%CI:1.378~4.589,P=0.028),高CAR组胃癌患者术后死亡的风险是低CAR组患者的1.926倍(HR:1.926,95%CI:1.564~3.853,P=0.025)。结论HER2以及CAR为胃癌患者术后肿瘤复发转移和死亡的独立预Objective To investigate the impact of human epidermal growth factor receptor 2(HER2)and C-reactive protein/albumin ratio(CAR)on the long-term survival of gastric cancer patients after surgery.Methods A retrospective analysis was conducted on 136 gastric cancer patients admitted to Lishui Central Hospital from January 2015 to December 2017,who underwent radical surgery and were followed up for 5 years.Patients were divided into HER2 positive and HER2 negative groups based on HER2 immunohistochemical results,and into high CAR and low CAR groups based on the CAR mean value.The relationship between HER2 and CAR with clinicopathological characteristics of gastric cancer patients was analyzed.The postoperative tumor-free survival rate and overall survival rate were compared between the two groups of patients(HER2 positive group and HER2 negative group,as well as high CAR group and low CAR group).Cox regression analysis was used to identify independent prognostic factors for postoperative tumor recurrence,metastasis,and death in gastric cancer patients.Results The proportion of HER2 positive patients with large tumor size,low differentiation,T_(3-4)tumor invasion depth,lymph node metastasis,and vascular invasion was significantly higher than that of HER2 negative patients(all P<0.05).The proportion of high CAR patients with large tumor size,low differentiation,T_(3-4)tumor invasion depth,lymph node metastasis,and vascular invasion was significantly higher than that of low CAR patients(all P<0.05).Kaplan-Meier survival analysis showed that HER2 negative patients had significantly higher 1-year,3-year,and 5-year cumulative tumor-free survival rate and overall survival rate than HER2 positive patients,while low CAR patients had significantly higher 1-year,3-year,and 5-year cumulative tumor-free survival rate and overall survival rate than high CAR patients(all P<0.05).Multivariate Cox regression analysis identified T_(3-4)tumor invasion depth,lymph node metastasis,HER2 positivity,and high CAR expression as independent pro

关 键 词：胃肿瘤 人表皮生长因子受体2 C反应蛋白质 白蛋白 无瘤生存期 

分 类 号：R735.2[医药卫生—肿瘤]