[人表皮生长因子受体2在进展期胃癌中的表达及其与临床特征、结局和预后的相关性]

[HER-2 expression in advanced gastric cancer and its correlation with clinical features, outcome and prognosis].

作者信息

Wang Yan, Xu Jian-ming, Liu Jian-zhi, Lin Li, Ge Fei-jiao, Li Shan-shan, Liu Lie-jun, Zhao Chuan-hua

机构信息

Academy of Military Medical Sciences, Beijing, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2011 Sep;33(9):671-5.

PMID:22340047

Abstract

OBJECTIVE

To assess the HER-2 status in Chinese advanced gastric cancer patients and explore its correlation with clinical features, treatment response and prognosis.

METHODS

A total of 107 patients with advanced gastric cancer treated in our hospital from December 2005 to November 2008 were included in this retrospective analysis. HER-2 status was determined by immunohistochemisty (IHC) and/or fluorescence in situ hybridization (FISH). The correlations of HER-2 status with tumor location, pathology, treatment response and prognosis were analyzed and the efficacy of different chemottherapy regimens was compared.

RESULTS

The overall positive rate of HER-2 expression was 14.7% (15/102). The HER-2 status was detected by both methods in 102 patients, and the concordance of the two methods was 66.5%. The tumor site distribution was gastroesophageal junction (GEJ) 28.0%, proximal stomach 19.4%, gastric corpus 16.1%, antrum 26.9% and whole stomach 9.7%, respectively. There was no significant difference of HER-2 status among different tumor sites (P = 0.726), and no significant correlation between HER-2 expression and differentiation (P = 0.110). Among the evaluable 51 patients treated by first-line chemotherapy, the total objective effective rate was 23.5%. The median time-to-progression was 7.47 months, and median overall survival time was 11.07 months. The effective rate was 43.8% in patients who received XP regimen chemotherapy (cisplatin + capecitabine), significantly higher than the 14.3% in patients treated with other regimens (P = 0.033). Their overall survival was 14.17 months and 9.53 months, respectively (P = 0.059). The TTP was 6.63 months in HER-2 positive patients and 7.47 months in HER-2 negative patients, with a non-significant difference (P = 0.510). However, there was a improving tendency in the efficacy and OS, showing a effective rate of 45.5% and 17.5% (P = 0.102) and OS of 14.17 months and 10.63 months, respectively (P = 0.205).

CONCLUSIONS

HER-2-positivity rate in Chinese patients with advanced gastric cancer is similar to those reported in the literature. Along with the increasing use of targeted therapy and targeted agents, the efficacy and survival of gastric cancer patients is improving. HER-2-positive patients may benefit from it.

摘要

目的

评估中国晚期胃癌患者的HER-2状态，并探讨其与临床特征、治疗反应及预后的相关性。

方法

本回顾性分析纳入了2005年12月至2008年11月在我院接受治疗的107例晚期胃癌患者。通过免疫组织化学（IHC）和/或荧光原位杂交（FISH）确定HER-2状态。分析HER-2状态与肿瘤位置、病理、治疗反应及预后的相关性，并比较不同化疗方案的疗效。

结果

HER-2表达的总体阳性率为14.7%（15/102）。102例患者通过两种方法检测HER-2状态，两种方法的一致性为66.5%。肿瘤部位分布分别为胃食管交界（GEJ）28.0%、胃近端19.4%、胃体16.1%、胃窦26.9%和全胃9.7%。不同肿瘤部位的HER-2状态无显著差异（P = 0.726），HER-2表达与分化之间无显著相关性（P = 0.110）。在可评估的51例接受一线化疗的患者中，总客观有效率为23.5%。疾病进展时间中位数为7.47个月，总生存时间中位数为11.07个月。接受XP方案化疗（顺铂+卡培他滨）的患者有效率为43.8%，显著高于接受其他方案治疗的患者的14.3%（P = 0.033）。他们的总生存期分别为14.17个月和9.53个月（P = 0.059）。HER-2阳性患者的疾病进展时间为6.63个月，HER-2阴性患者为7.47个月，差异无统计学意义（P = 0.510）。然而，疗效和总生存期有改善趋势，有效率分别为45.5%和17.5%（P = 0.102），总生存期分别为14.17个月和10.63个月（P = 0.205）。