Huang Kuo-Hung, Lan Yuan-Tzu, Chen Ming-Huang, Chao Yee, Lo Su-Shun, Li Anna Fen-Yau, Wu Chew-Wun, Chiou Shih-Hwa, Yang Muh-Hwa, Shyr Yi-Ming, Fang Wen-Liang
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan.
World J Surg. 2015 Sep;39(9):2289-99. doi: 10.1007/s00268-015-3095-4.
The expression of RhoA, a member of the ras homologue family, is reported to be involved in tumorigenesis in some cancers; however, its prognostic value in gastric cancer is controversial.
Between April 1988 and January 2005, a total of 206 gastric cancer patients receiving curative surgery were enrolled in this study. Immunohistochemical staining of the RhoA protein was performed, and the clinicopathological characteristics and initial recurrence patterns were compared between low RhoA expression (n = 55) and high RhoA expression (n = 151) gastric cancer patients.
For intestinal-type (n = 134) gastric cancer, there is no significant difference between the clinicopathological characteristics and RhoA expression. However, for diffuse-type (n = 82) gastric cancer, high RhoA expression was associated with more advanced pathological N category compared to low RhoA expression. A multivariate analysis revealed that age, pathological T and N categories, and RhoA expression were independent prognostic factors for overall survival after curative surgery. For all patients, the five-year overall survival rates and disease-free survival rates were higher in patients with low RhoA expression compared to those with high RhoA expression, which was observed in diffuse-type gastric cancer, not in intestinal-type gastric cancer. With regard to the initial recurrence pattern, patients with high RhoA expression had more distant metastasis compared to those with low RhoA expression, especially more liver metastasis.
RhoA expression is an independent prognostic factor for gastric cancer, especially for diffuse-type. We should be aware of liver metastasis during the follow-up of gastric cancer with high RhoA expression.
据报道，ras同源家族成员RhoA的表达与某些癌症的肿瘤发生有关；然而，其在胃癌中的预后价值存在争议。
1988年4月至2005年1月，共有206例接受根治性手术的胃癌患者纳入本研究。进行了RhoA蛋白的免疫组织化学染色，并比较了低RhoA表达（n = 55）和高RhoA表达（n = 151）胃癌患者的临床病理特征和初始复发模式。
对于肠型（n = 134）胃癌，临床病理特征与RhoA表达之间无显著差异。然而，对于弥漫型（n = 82）胃癌，与低RhoA表达相比，高RhoA表达与更晚期的病理N分期相关。多因素分析显示，年龄、病理T和N分期以及RhoA表达是根治性手术后总生存的独立预后因素。对于所有患者，低RhoA表达患者的五年总生存率和无病生存率高于高RhoA表达患者，这在弥漫型胃癌中观察到，而在肠型胃癌中未观察到。关于初始复发模式，高RhoA表达患者比低RhoA表达患者有更多远处转移，尤其是更多肝转移。
RhoA表达是胃癌尤其是弥漫型胃癌的独立预后因素。在对高RhoA表达的胃癌患者进行随访时，我们应注意肝转移。
