胃癌人表皮生长因子受体2表达特征及其与预后的关系  

Clinicopathological features and prognostic significance of human epidermal growth factor receptor 2 in gastric carcinoma

作　　者：寇梦瑛 王朝阳[1,2] 杜日昌[2] 张涛[2] 俸敏[2] 邓伶俐[1,2] 张相国[2] 钟纯兰 崔磊[2] 王教成[2] 

机构地区：[1]广东医科大学附属医院肿瘤中心,湛江524001 [2]汕头大学医学院附属粤北人民医院放疗科,韶关512026

出　　处：《肿瘤研究与临床》2016年第7期441-446,共6页Cancer Research and Clinic

基　　金：韶关市科技计划（2014CX/K199）;韶关市卫生计生科研项目（Y15051）

摘　　要：目的：探讨人表皮生长因子受体2（HER2）在胃癌中的表达特征及其与预后的关系。方法回顾性分析127例胃癌患者临床病理资料。119例（93.7%）患者行R0切除，123例（96.9%）行D2淋巴结清扫术，51例（40.2%）行术后辅助化疗。所有患者均采用免疫组织化学染色技术检测胃癌组织中HER2的表达。分析HER2表达与临床病理特征的关系及患者生存情况。结果胃癌组织中HER2阳性率为8.7%（11／127）。HER2阳性和HER2阴性患者淋巴结转移率分别为100.0%（11／11）、81.9%（95／116），差异有统计学意义（P＝0.041）。HER2阳性和阴性胃癌患者的3年总生存（OS）率分别为32.7%和42.9%，3年无进展生存（PFS）率分别为27.3%和42.2%，差异无统计学意义（P＝0.413，P＝0.354）。对于HER2阴性的胃癌患者，单纯手术（71例）与手术＋术后辅助化疗患者（45例）的3年OS率分别为35.4%和55.3%（P＝0.015），3年PFS率分别为35.3%和53.3%（P＝0.038）；对于HER2阳性的胃癌患者，单纯手术（5例）与手术＋术后辅助化疗（6例）的3年OS率分别为75.0%和0（P＝0.002），3年PFS率分别为60.0%和0（P＝0.004）。结论HER2在胃癌组织中有一定表达并与肿瘤淋巴结转移有关。 HER2状态和胃癌的预后无相关性，但可能用于指导胃癌术后辅助治疗。Objective To explore the clinicopathological features and prognostic significance of human epidermal growth factor receptor 2 （HER2） in gastric carcinoma. Methods Pathological data of 127 patients with gastric carcinoma were retrospectively analyzed. HER2 expressions of all patients were detected by immunohistochemistry （IHC）. 119 （93.7 %） patients were undergone R0 dissection and 123 （96.9 %） cases received D2 lymph nodes dissection. 51 （40.2 %） patients received adjuvant chemotherapy. The proportional differences of clinicopathological features for patients between HER2-positive and HER2-negative were compared, including the patients＆#39; survival. Results HER2 overexpression rate was 8.7 % （11/127） in gastric carcinoma patients. For the patients with HER2-positive and HER-negative, the lymph node metastasis rates were 100.0 % （11/11） and 81.9 % （95/116）, respectively （P= 0.041）. The 3-year overall survival （OS） rates for HER2-positive and HER2- negative patients with gastric carcinoma were 32.7 % and 42.9 % （P=0.413）, and the 5-year progression free survival （PFS） rates were 27.3 % and 42.2 % （P = 0.354）, respectively. Among patients with HER2-negative, 3-year OS rate for patients with surgery plus adjuvant chemotherapy was 55.3%, compared with 35.4%for patients with surgery alone （P=0.015）, and the 3-year PFS rates were 53.3 % and 35.3 % （P= 0.038）, respectively. Among patients with HER2-positive patients, 3-year OS rate for patients with surgery plus adjuvant chemotherapy was 0, compared with 75.0%for patients with surgery alone （P=0.002）, and the 3-year PFS rates were 0 and 60.0% （P=0.004）. Conclusions HER2 is expressed in gastric carcinoma tissue, related to lymph node metastasis. HER2 status are not correlated with the prognosis for gastric carcinoma patients, however, it is likely to be a predictive marker for adjuvant treatment after surgery for patients with gastric carcinoma.

关 键 词：胃肿瘤 人表皮生长因子受体2 预后 

分 类 号：R735.2[医药卫生—肿瘤]