Qu Jian-jun, Shi Yi-ran, Hao Feng-yun
Department of Oncology, People's Hospital of Weifang City, Shandong Weifang 261041, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Mar;16(3):276-80.
To investigate the predictive value of seven gastric cancer-associated factors on neoadjuvant chemotherapy in patients with advanced gastric cancer.
Expressions of C-met, EGFR, HER2, Ki-67, MMP7, P53 and TOPOII were detected by immunohistochemistry in gastric cancer tissues of 53 cases before and after mFOLFOX7 neoadjuvant chemotherapy. Chemotherapy efficacy was evaluated according to RECIST 1.1 standard combined with histopathology, and the relationship between various genes and chemotherapy efficacy was analyzed by univariate and logistic multivariate regression analyses.
The clinical response rate was 52.8% (28/53) in neoadjuvant chemotherapy, including complete response in none, partial response in 28 cases (52.8%), stable disease in 24 cases (45.3%) and progressive disease in 1 case (1.9%). The expressions of all the genes were not significantly different before and after neoadjuvant chemotherapy (P>0.05). Neoadjuvant chemotherapy efficacy was 83.3% (10/12) in the patients of HER2 positive expression and 43.9% (18/41) in the patients of HER2 negative expression. The former was significant higher than the latter (P=0.016). Response rate of patients with P53 positive expression was 35.7% (10/28), significantly lower than 72.0% (18/25) of those with P53 negative expression (P=0.008). Six patients with both HER2 positive expression and P53 negative expression showed better efficacy. The expressions of C-met, EGFR, Ki-67, MMP7 and TOPOII were not associated with response to neoadjuvant chemotherapy (P>0.05). HER2 and P53 were independent influencing factors of neoadjuvant chemotherapy (P<0.05).
Expressions of HER2 and P53 have great value in the prediction of mFOLFOX7 neoadjuvant chemotherapy efficacy, suggesting that as independent factors, HER2 and P53 may be used to predict the efficacy before chemotherapy.
探讨7种胃癌相关因素对进展期胃癌患者新辅助化疗的预测价值。
采用免疫组织化学法检测53例进展期胃癌患者在mFOLFOX7新辅助化疗前后癌组织中C-met、表皮生长因子受体（EGFR）、人表皮生长因子受体2（HER2）、Ki-67、基质金属蛋白酶7（MMP7）、P53及拓扑异构酶II（TOPOII）的表达。根据实体瘤疗效评价标准（RECIST）1.1结合组织病理学评估化疗疗效，采用单因素及logistic多因素回归分析各基因与化疗疗效的关系。
新辅助化疗的临床有效率为52.8%（28/53），其中无完全缓解病例，部分缓解28例（52.8%），病情稳定24例（45.3%），病情进展1例（1.9%）。新辅助化疗前后各基因表达差异均无统计学意义（P>0.05）。HER2阳性表达患者新辅助化疗有效率为83.3%（10/12），HER2阴性表达患者为43.9%（18/41），前者显著高于后者（P=0.016）。P53阳性表达患者的有效率为35.7%（10/28），显著低于P53阴性表达患者的72.0%（18/25）（P=0.008）。6例HER2阳性且P53阴性表达患者疗效较好。C-met、EGFR、Ki-67、MMP7及TOPOII的表达与新辅助化疗疗效无关（P>0.05）。HER2及P53是新辅助化疗的独立影响因素（P<0.05）。
HER2及P53表达对mFOLFOX7新辅助化疗疗效具有重要预测价值，提示HER2及P53作为独立因素可在化疗前预测疗效。
