Lieto Eva, Ferraraccio Francesca, Orditura Michele, Castellano Paolo, Mura Anna La, Pinto Margherita, Zamboli Anna, De Vita Ferdinando, Galizia Gennaro
Divisions of Surgical Oncology, F. Magrassi - A. Lanzara Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, c/o II Policlinico, Edificio 17, Via Pansini, 5, 80131, Naples, Italy.
Ann Surg Oncol. 2008 Jan;15(1):69-79. doi: 10.1245/s10434-007-9596-0. Epub 2007 Sep 26.
Unlike other human tumors, gastric cancer remains a great therapeutic challenge since no standardized postoperative treatment exists. Knowledge of molecular pathways determining the behavior of individual gastric tumors seems to be crucial for therapeutic decisions, and evaluation of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) expression might be critical for prognosis, assessment, and identification of patients that could be treated with tailored therapies.
VEGF and EGFR determination was performed in 88 gastric cancer samples as well as 25 normal gastric mucosa specimens from non-cancer patients using a commercially available immunohistochemistry kit. In all samples, the correlation of VEGF and EGFR expression was investigated with each other, and with other prognostic indicators in all samples, and, finally, with survival rates in 69 patients undergoing potentially curative surgery.
Forty-eight per cent (42 cases) of gastric cancers expressed VEGF, and 44% (39 cases) stained for EGFR. In curatively treated patients, VEGF and EGFR expression was demonstrated to correlate with worse survival in both univariate and multivariate analyses. Molecular profiling was shown to more accurately estimate the risk of cancer-related death than TNM stage, and, of most interest, to allow sorting out high-risk patients within the same stage.
These findings provide evidence that contemporary evaluation of VEGF and EGFR expression may be crucial to select gastric cancer patients with poor prognosis who may benefit of tailored treatments.
与其他人类肿瘤不同，由于不存在标准化的术后治疗方法，胃癌仍然是一个巨大的治疗挑战。了解决定个体胃癌行为的分子途径似乎对治疗决策至关重要，而评估血管内皮生长因子（VEGF）和表皮生长因子受体（EGFR）的表达可能对预后评估以及识别可接受个体化治疗的患者至关重要。
使用市售免疫组织化学试剂盒对88例胃癌样本以及25例来自非癌症患者的正常胃黏膜标本进行VEGF和EGFR检测。在所有样本中，研究VEGF和EGFR表达之间的相关性，以及与所有样本中的其他预后指标的相关性，最后研究与69例接受根治性手术患者的生存率的相关性。
48%（42例）的胃癌表达VEGF，44%（39例）EGFR染色阳性。在接受根治性治疗的患者中，单因素和多因素分析均显示VEGF和EGFR表达与较差的生存率相关。分子谱分析显示比TNM分期更准确地估计癌症相关死亡风险，最有意思的是，能够在同一分期内筛选出高危患者。
这些发现提供了证据，表明当代对VEGF和EGFR表达的评估对于选择可能从个体化治疗中获益的预后不良的胃癌患者可能至关重要。
