上尿路上皮癌患者中人表皮生长因子受体-2表达的临床意义  

Clinical significance of human epidermal growth factor receptor-2 expression in patients with upper urothelial carcinoma

作　　者：康曦 刘方[1] 杨帆 龙宇 刘各亮 KANG Xi;LIU Fang;YANG Fan;LONG Yu;LIU Geliang(Department of Urology,Pingxiang People's Hospital,Jiangxi Province,Pingxiang 337099,China;Department of Urology,Ganxi Cancer Hospital,Jiangxi Province,Pingxiang 337000,China;Department of Urology,General Hospital of Pingxiang Mining Group Co.,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院泌尿外科,江西萍乡337099 [2]江西省赣西肿瘤医院泌尿外科,江西萍乡337000 [3]江西省萍矿总医院泌尿外科,江西萍乡337000

出　　处：《中国当代医药》2023年第36期94-98,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202311702)。

摘　　要：目的 探讨上尿路上皮癌中人表皮生长因子受体-2(HER2)表达的临床意义。方法 选取2010年11月至2021年11月萍乡市人民医院接受肾输尿管切除术的171例上尿路上皮癌患者作为研究对象,并收集其肿瘤组织作为标本,采用免疫组织化学法检测HER2的表达情况,然后采用荧光原位杂交法检测HER2基因扩增,明确HER2基因扩增状态。收集171例上尿路上皮癌患者的临床资料并进行为期1年的随访,并采用Kaplan-Meier以及多变量COX比例风险回归模型,分析HER2基因扩增与上尿路上皮癌肿瘤临床病理以及预后情况的关系。结果通过免疫组织化学法检测发现,171例上尿路上皮癌患者中HER2阳性率为29.24%(50/171)。不同性别、TNM分期的上尿路上皮癌HER2阳性表达患者比较,差异有统计学意义(P<0.05)。通过Kaplan-Meier生存分析发现,上尿路上皮癌HER2表达阳性患者的总生存率和疾病特异生存率低于HER2表达阴性患者,差异有统计学意义(P<0.05)。通过多变量COX比例风险回归模型分析发现,上尿路上皮癌患者的年龄、淋巴结转移、HER2阳性是上尿路上皮细胞患者预后的独立危险因素(P<0.05)。结论 HER2基因过表达和基因扩增与上尿路上皮癌病情恶化具有一定的关联,HER2基因过表达是影响肾输尿管切除术后膀胱复发时间缩短的独立危险因素,且HER2基因过表达表明上尿路上皮癌患者预后状况较差。Objective To investigate the clinical significance of human epidermal growth factor receptor-2(HER2) expression in upper urothelial carcinoma.Methods A total of 171 patients with upper urothelial carcinoma who underwent nephreterectomy in Pingxiang People's Hospital from November 2010 to November 2021 were selected as study objects,and their tumor tissues were collected as samples.HER2 expression was detected by immunohistochemistry,and HER2 gene amplification was detected by fluorescence in situ hybridization.The amplification status of HER2 gene was determined.Clinical data of 171 patients with upper urothelial carcinoma were collected and followed up for 1 year.Kaplan-Meier and multivariate COX proportional risk regression models were used to analyze the relationship between HER2 gene amplification and the clinicopathology and prognosis of upper urothelial carcinoma.Results The positive rate of HER2 in 171 patients with upper urothelial carcinoma was 29.24%(50/171) by immunohistochemistry.There was statistical significances in HER2 positive expression of upper urothelial carcinoma patients of different genders and TNM stages(P<0.05).Kaplan-Meier survival analysis showed that the overall survival rate and disease-specific survival rate of patients with positive expression of HER2 in upper urothelial carcinoma were lower than those with negative expression of HER2,with statistical significances(P<0.05).Multivariate COX proportional hazard regression model analysis showed that age,lymph node metastasis and HER2 positivity were independent risk factors for prognosis of upper urothelial carcinoma(P<0.05).Conclusion HER2 gene overexpression and gene amplification are associated with the progression of upper urothelial carcinoma.HER2 gene overexpression is an independent risk factor for shortening the time of bladder recurrence after nephreterectomy,and HER2 gene overexpression indicates poor prognosis in upper urothelial carcinoma patients.

关 键 词：上尿路上皮癌 人表皮生长因子受体-2 过度表达 临床意义 

分 类 号：R737.1[医药卫生—肿瘤]