HER2蛋白水平预测胃癌患者根治术后无瘤生存期和总生存期  

HER2 protein levels predict tumor-free survival and overall survival after radical gastrectomy for gastric cancer patients

作　　者：吕姣[1] 袁成[2] 赵鸿鹰 石然 朱梅[1] LYU Jiao;YUAN Cheng;ZHAO Hongying;SHI Ran;ZHU Mei(Department of Medical Oncology,Xuzhou Cancer Hospital,Jiangsu Xuzhou 221005,China;Department of Radiotherapy,Xuzhou Cancer Hospital,Jiangsu Xuzhou 221005,China)

机构地区：[1]徐州市肿瘤医院肿瘤内科,江苏徐州221005 [2]徐州市肿瘤医院放疗科,江苏徐州221005

出　　处：《现代肿瘤医学》2023年第24期4567-4571,共5页Journal of Modern Oncology

基　　金：江苏省卫生健康委科研项目(编号:Z2022097);江苏省徐州市卫生健康委科技项目(编号:XWKYHT20200042);江苏省徐州市科技项目(编号:KC22148)。

摘　　要：目的:探讨HER2蛋白对胃癌患者根治术后无瘤生存期和总生存期的评估价值。方法:将所有纳入研究的患者按术后HER2蛋白病理检查结果分为HER2蛋白阳性组和HER2蛋白阴性组,t检验或χ^(2)检验比较两组各项临床病理指标,运用1∶1倾向性匹配评分法将Logistic模型估计的倾向性评分相近患者进行配对,再次检验匹配后两组间各临床病理特征的均衡性,Kaplan-Meier生存分析比较匹配后两组术后无瘤生存率和总生存率,Cox回归模型进行敏感性分析,验证HER2蛋白对胃癌根治术后患者生存情况的评估价值。结果:研究共纳入354例接受根治手术的胃癌患者,平均年龄(55.82±11.28)岁,其中男性234例(66.1%),女性120例(33.9%),术后5年无瘤生存率和总生存率分别为41.2%和55.7%。匹配后两组间各项临床病理指标达到均衡一致,无明显差异。Kaplan-Meier生存分析显示,匹配后HER2阴性胃癌患者术后1年、3年、5年累积无瘤生存率明显高于HER2阳性胃癌患者(83.4%、58.3%、54.3%vs 71.2%、39.1%、30.8%,P=0.019),HER2阴性胃癌患者术后1年、3年、5年累积总生存率明显高于HER2阳性胃癌患者(100%、87.9%、73.4%vs 88.6%、55.6%、51.2%,P=0.035),Cox分析显示:HER2阳性胃癌患者术后复发转移的风险是HER2阴性患者的2.132倍(OR:2.132,95%CI:1.524~2.743,P=0.021),HER2阳性胃癌患者术后死亡的风险是HER2阴性患者的1.783倍(OR:1.783,95%CI:1.136~2.435,P=0.028)。结论:HER2蛋白为影响胃癌患者术后生存情况的独立预测因子,HER2阳性胃癌患者术后肿瘤复发转移的风险更高,术后生存期更短。Objective:To investigate the value of HER2 expression protein in the evaluation on tumor free and overall survival after radical gastrectomy for gastric cancer patients.Methods:All the patients included in the study were divided into HER2 protein positive group or HER2 protein negative group according to the postoperative HER2 protein pathological examination results,t-test orχ^(2)-test was used to compare the clinicopathological indexes between the two groups.1∶1 propensity matching score method was applied to match the patients with similar propensity scores estimated by Logistic model,and the equilibrium of each clinicopathological feature between the two groups after matching was tested again.Kaplan-Meier survival analysis was performed to compare the postoperative tumor-free survival rate and overall survival rate between the two groups after matching,and Cox regression model was used for sensitivity analysis to verify the value of HER2 protein expression in the evaluation of survival after radical gastrectomy.Results:A total of 354 patients with gastric cancer who underwent radical surgery were included in the study,with an average age of(55.82±11.28)years,including 234 males(66.1%)and 120 females(33.9%),and the 5-year postoperative tumor-free survival rate and overall survival rate were 41.2%and 55.7%,respectively.After matching,the clinicopathological parameters between the two groups were balanced and consistent,with no significant difference.Kaplan-Meier survival analysis showed that the 1-year,3-year and 5-year cumulative tumor-free survival rates postoperatively were significantly higher in patients with HER2 negative gastric cancer than in the patients with HER2 positive gastric cancer after matching(83.4%,58.3%,54.3%vs 71.2%,39.1%,30.8%,P=0.019),and the 1-year,3-year and 5-year cumulative overall survival rates postoperatively were significantly higher in HER2 negative gastric cancer patients than in HER2 positive gastric cancer patients(100%,87.9%,73.4%vs 88.6%,55.6%,51.2%,P=0.035).Cox analysis

关 键 词：HER2蛋白 胃癌 根治术 无瘤生存期 总生存期 

分 类 号：R735.2[医药卫生—肿瘤]