Department of Abdominal Surgery, Fudan University, Shanghai Cancer Center, Shanghai, China.
J Surg Oncol. 2011 Jul 1;104(1):76-82. doi: 10.1002/jso.21896. Epub 2011 Mar 11.
The aim of this study was firstly to elucidate the prognosis of familial gastric cancer (FGC) in Chinese population.
A total of 162 patients were recruited, including 81 patients with FGC and 81 patients with sporadic gastric cancer (SGC), who underwent gastrectomy between 1996 and 2007. Paraffin-embedded tumor specimens were obtained from tissue bank of Cancer Hospital, Fudan University. The expression of epidermal growth factor receptor (EGFR), P53, C-myc, and proliferating cell nuclear antigen (PCNA) were detected by immunohistochemical method.
There were significant differences in tumor size, vessel invasion, EGFR, and P53 expression between FGC and SGC patients. The 5-year survival rates were 48% and 57% in FGC and SGC patients, respectively (P = 0.033). Subgroup analysis showed that the 5-year survival rates were worse in FGC patients with nerve invasion, high PCNA expression, negative expression of EGFR, and positive expression of P53 than those in SGC group. Multivariate analysis showed that AJCC stage, tumor size, and nerve invasion were independent prognostic factors in all patients. Furthermore, AJCC stage and P53 expression dramatically affected the prognosis of FGC patients.
The prognosis of FGC patients might be worse than those of SGC patients. AJCC stage and P53 expression are independent prognostic factors in FGC patients.
本研究旨在阐明中国人群家族性胃癌（FGC）的预后。
共纳入 162 例患者，包括 81 例 FGC 患者和 81 例散发性胃癌（SGC）患者，他们于 1996 年至 2007 年间接受了胃切除术。来自复旦大学附属肿瘤医院的组织库获得了石蜡包埋的肿瘤标本。采用免疫组织化学方法检测表皮生长因子受体（EGFR）、P53、C-myc 和增殖细胞核抗原（PCNA）的表达。
FGC 和 SGC 患者的肿瘤大小、血管侵犯、EGFR 和 P53 表达存在显著差异。FGC 和 SGC 患者的 5 年生存率分别为 48%和 57%（P=0.033）。亚组分析显示，FGC 患者中存在神经侵犯、PCNA 高表达、EGFR 阴性和 P53 阳性的患者 5 年生存率较 SGC 组差。多因素分析显示，AJCC 分期、肿瘤大小和神经侵犯是所有患者的独立预后因素。此外，AJCC 分期和 P53 表达显著影响 FGC 患者的预后。
FGC 患者的预后可能较 SGC 患者差。AJCC 分期和 P53 表达是 FGC 患者的独立预后因素。
