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HER-2/neu基因扩增是胃癌的一个独立预后因素。

HER-2/neu amplification is an independent prognostic factor in gastric cancer.

作者信息

Park Dong Il, Yun Jung Won, Park Jung Ho, Oh Suk Joong, Kim Hong Joo, Cho Yong Kyun, Sohn Chong Il, Jeon Woo Kyu, Kim Byung Ik, Yoo Chang Hak, Son Byung Ho, Cho Eun Yoon, Chae Seoung Wan, Kim Eo-Jin, Sohn Jin Hee, Ryu Seung Ho, Sepulveda Antonia R

机构信息

Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Dig Dis Sci. 2006 Aug;51(8):1371-9. doi: 10.1007/s10620-005-9057-1. Epub 2006 Jul 26.

Abstract

The HER-2/neu protein is intimately involved with normal cell proliferation and tissue growth and is extensively homologous and related to the epidermal growth factor receptor. HER-2/neu protein expression has been most intensively studied in the context of breast carcinoma, in which its amplification and overexpression correlate with the overall course of disease, and with a poor prognosis, and constitute a predictive factor of poor response to chemotherapy and endocrine therapy. In this study, we investigated the relationship between the expression of HER-2/neu and the clinicopathological characteristics of tumors, including survival. This study was performed with a view toward the future introduction of Herceptin therapy for gastric cancer patients. HER-2/neu overexpression and gene amplification was examined with semiquantitative standardized immunohistochemical staining, chromogenic in situ hybridization (CISH), and fluorescence in situ hybridization (FISH) in 182 gastric cancer patients who underwent curative surgery at the Kangbuk Samsung Hospital. Twenty-nine (15.9%) of 182 patients expressed the HER-2/neu protein by immunohistochemistry. HER-2/neu gene amplification was detected in seven patients by CISH and FISH. Intestinal-type cancers exhibited higher rates of HER-2/neu amplification than did diffuse-type cancers (P < 0.05). Tumors with HER-2/neu amplification were associated with poor mean survival rates (922 vs 3243 days) and 5-year survival rates (21.4% vs 63.0%; P < 0.05). Age, TNM stage, and amplification of HER-2/neu were found to be independently related to survival by multivariate analysis. HER-2/neu amplification may constitute an independent prognostic factor in gastric cancer patients, and patients exhibiting HER-2/neu amplification might constitute potential candidates for new adjuvant therapies which involve the use of humanized monoclonal antibodies.

摘要

HER-2/neu蛋白与正常细胞增殖和组织生长密切相关,与表皮生长因子受体具有广泛的同源性和相关性。HER-2/neu蛋白表达在乳腺癌研究中最为深入,其扩增和过表达与疾病的整体进程相关,且预后较差,是化疗和内分泌治疗反应不佳的预测因素。在本研究中,我们调查了HER-2/neu表达与肿瘤临床病理特征(包括生存率)之间的关系。本研究旨在为未来胃癌患者引入赫赛汀治疗。我们采用半定量标准化免疫组织化学染色、显色原位杂交(CISH)和荧光原位杂交(FISH),对182例在江北三星医院接受根治性手术的胃癌患者进行了HER-2/neu过表达和基因扩增检测。182例患者中有29例(15.9%)通过免疫组织化学检测显示HER-2/neu蛋白表达。通过CISH和FISH在7例患者中检测到HER-2/neu基因扩增。肠型癌的HER-2/neu扩增率高于弥漫型癌(P<0.05)。HER-2/neu扩增的肿瘤患者平均生存率(922天对3243天)和5年生存率较低(21.4%对63.0%;P<0.05)。多因素分析发现,年龄、TNM分期和HER-2/neu扩增与生存率独立相关。HER-2/neu扩增可能是胃癌患者的独立预后因素,表现出HER-2/neu扩增的患者可能是涉及使用人源化单克隆抗体的新辅助治疗的潜在候选者。

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