食管鳞癌中人表皮生长因子受体Her-2/neu蛋白的过表达及预后意义  

Overexpression and prognostic significance of HER-2/neu in patients with esophageal squamous cell carcinoma

作　　者：邓勇军[1] 李海滨[1] 沈剑[2] 杨鸿生[1] 洪志鹏[1] 李定彪[1] 

机构地区：[1]昆明医学院第一附属医院胸外科,云南昆明650032 [2]昆明医学院第一附属医院病理科,云南昆明650032

出　　处：《中国现代医学杂志》2009年第24期3726-3730,共5页China Journal of Modern Medicine

基　　金：云南省教育厅资助项目(No:08C0111)

摘　　要：目的分析食管鳞癌中Her-2/neu蛋白过表达的临床病理意义及其对预后的影响,探讨以Her-2/neu单抗对过表达Her-2/neu蛋白的食管鳞癌患者进行靶向治疗的可行性。方法应用Hercep Test试剂盒,对94例外科切除、病理诊断为食管鳞癌的标本中Her-2/neu蛋白的表达水平进行检测,并分析Her-2/neu蛋白的过表达与临床病理特征的关系以及与患者预后的关系。结果HER-2/neu蛋白在癌旁组织及正常食管组织中的表达为阴性,在94例食管鳞癌中的过表达率为20.2%(19/94),其过表达与患者的性别、年龄、肿瘤部位、组织学分化程度、临床分期均无明显相关性(P>0.05),而与肿瘤浸润深度(T分期)以及淋巴结转移(N分期)具有一定的相关性,在T3+T4期的肿瘤组织中的过表达率明显高于T1+T2期的肿瘤组织中的过表达率(30.0%vs.13.0%),差异有统计学意义(χ2=4.136,P=0.039);在N1期肿瘤组织中的过表达率明显高于在N0期肿瘤组织中的过表达率(26.8%vs.10.6%),差异有统计学意义(χ2=3.711,P=0.045);生存分析显示HER-2/neu蛋白过表达组的总生存率低于非过表达组,差异有统计学意义(χ2=6.258,P=0.017),而两组的无瘤生存率差异无统计学意义(χ2=0.258,P=0.605);Cox模型多因素分析显示HER-2/neu基因过表达是影响患者总生存率的有意义的预后因素之一。结论HER-2/neu基因过表达与食管鳞癌的浸润转移及预后密切相关,HER-2/neu蛋白过表达检测可作为判断食管鳞癌生物学行为和预测预后的参考指标之一,并为HER-2/neu过表达的病例应用HER-2/neu单克隆抗体进行靶向治疗提供依据。【Objectives】To investigate the clinicopathological significance of the overexpression of HER-2/neu oncoprotein in esophageal squamous cell carcinoma （ESCC） and its influence on prognosis of patients with ESCC,and evaluate the feasibility of targeting therapy with anti-Her-2/neu antibody to patients with HER-2/neu overexpressing ESCC.【Methods】The expression levels of HER-2/neu oncoprotein in 94 specimens of patients with ESCC were detected using the HercepTest kit according to the manufacturer＇s instructions.Correlation of HER-2/neu oncoprotein overexpression to clinicopathological features and prognosis of patients with ESCC were analyzed.【Results】The expression of HER-2/neu oncoprotein was not observed in normal esophageal tissues and paracancerous tissues.The overexpression rate of HER-2/neu oncoprotein was 20.2% （19/94） in ESCC tissues.The overexpression of HER-2/neu oncoprotein had no correlation to gender,age,tumor location,histological grade and TNM staging （P 〉0.05）,but correlated to infiltrating depth of tumor （T stage） and lymph node metastasis.The overexpression rate of HER-2/neu oncoprotein in T3＋T4 ESCC was significantly higher than that in T1＋T2 ESCC （30.0% vs.13.0%,χ^2= 4.136,P =0.039）;the overexpression rate of HER-2/neu in N1 ESCC was significantly higher than that in N0 ESCC （26.8% vs.10.6%,χ^2=3.711,P =0.045）.Univariate analysis showed that statistically significant difference was found in the overall survival （χ^2=6.258,P =0.017）,but no statistically significant difference was found in terms of diseasefree survival （χ^2=0.258,P =0.605）;cox multivariate analysis indicated that HER-2/neu oncoprotein overexpression was one of independent prognostic factors of ESCC.【Conclusions】HER-2/neu oncoprotein overexpression may correlate to tumor infiltrating,metastasis and indicated poor prognosis of ESCC.Detecting HER-2/neu oncoprotein overexpression can evaluate the biological behaviour of ESCC and predict prognosis of patients with ESCC,and supp

关 键 词：食管肿瘤 表皮生长因子受体-2 过表达 预后 

分 类 号：R392.33[医药卫生—免疫学]