Department of Surgery, South Western Sydney Upper GI Surgical Unit, Bankstown Hospital, University of Western Sydney, Bankstown, NSW 2200, Sydney, Australia.
Int J Cancer. 2012 Jun 15;130(12):2845-56. doi: 10.1002/ijc.26292. Epub 2011 Nov 17.
With the availability of a therapeutic target and an effective agent in trastuzumab, a systematic examination of the literature to investigate the role of human epidermal growth factor 2 (HER2) as a prognostic factor for survival and its association with clinicopathologic markers may improve treatment. An electronic search of the MEDLINE and PubMed databases (January 1990 to January 2011) was undertaken to identify translational studies that correlated HER2 with clinicopathologic markers and/or survival outcome. This review included 49 studies totaling 11,337 patients. Forty-four percent of patients had Stage I/II, and 56% had Stage III/IV disease. Immunohistochemistry was most commonly used to assess HER2 expression, identifying a median rate of 18% (range, 4-53%) of gastric cancer demonstrating HER2 overexpression. In patients with and without HER2 overexpression, the median 3-year disease-free survival rate was 58% (range, 50-88%) and 86% (range, 62-97%), respectively. Of the 35 studies reporting the impact of HER2 overexpression on survival, 20 studies (57%) reported no difference in overall survival, two studies (6%) reported significantly longer overall survival in patients with HER2 overexpression and 13 studies (37%) reported significantly poorer overall survival in patients with HER2 overexpression. The median overall survival and 5-year survival rate was 21 (range, 10-57) months and 42%, and 33 (range, 13-80) months and 52% in patients with and without HER2 overexpression, respectively. HER2 overexpression appears to be associated with poorer survival and with intestinal-type gastric cancer in this group of patients for whom majority undergone curative gastrectomy.
随着曲妥珠单抗这一治疗靶点和有效药物的出现，对文献进行系统检查，以研究人类表皮生长因子 2（HER2）作为生存预后因素的作用及其与临床病理标志物的关系，可能有助于改善治疗效果。我们对 MEDLINE 和 PubMed 数据库（1990 年 1 月至 2011 年 1 月）进行了电子检索，以确定将 HER2 与临床病理标志物和/或生存结果相关联的转化研究。本综述共纳入了 49 项研究，总计 11337 例患者。其中 44%的患者处于 I/II 期，56%的患者处于 III/IV 期。免疫组织化学法最常用于评估 HER2 的表达情况，中位 HER2 过表达率为 18%（范围：4%-53%）。在有和没有 HER2 过表达的患者中，中位 3 年无病生存率分别为 58%（范围：50%-88%）和 86%（范围：62%-97%）。在报道 HER2 过表达对生存影响的 35 项研究中，有 20 项（57%）研究报告总生存率无差异，有 2 项（6%）研究报告 HER2 过表达患者的总生存率显著延长，有 13 项（37%）研究报告 HER2 过表达患者的总生存率显著降低。HER2 过表达患者的中位总生存时间和 5 年生存率分别为 21（范围：10-57）个月和 42%，无 HER2 过表达患者的中位总生存时间和 5 年生存率分别为 33（范围：13-80）个月和 52%。在接受根治性胃切除术的这组患者中，HER2 过表达似乎与生存较差和肠型胃癌相关。
