Liu Xuechao, Xu Pengfei, Qiu Haibo, Liu Jianjun, Chen Shangxiang, Xu Dazhi, Li Wei, Zhan Youqing, Li Yuanfang, Chen Yingbo, Zhou Zhiwei, Sun Xiaowei
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China; Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
Onco Targets Ther. 2016 Feb 26;9:949-58. doi: 10.2147/OTT.S100979. eCollection 2016.
We sought to determine whether human epidermal growth factor receptor 2 (HER2) and vascular endothelial growth factor (VEGF) expression were independent prognostic factors for gastric cancer (GC).
A total of 678 consecutive patients with GC undergoing curative surgery between October 2010 and December 2012 had resected tissue examined for HER2 and VEGF expression using immunohistochemistry. Immunohistochemical expression of HER2 was analyzed using the DAKO-HercepTest™ and scored according to published reports. VEGF expression was calculated by multiplying the score for the percentage of positive cells by the intensity score. We defined positive expression as a score of 1+, 2+, or 3+, and a score of 0 was defined as negative expression. We compared these results to clinicopathological characteristics, including overall survival (OS).
Multivariate analysis revealed that HER2 expression was independently associated with shorter OS (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.10-2.18; P=0.01) and with higher tumor-nodes-metastasis stage (HR, 3.88; 95% CI, 2.67-5.64; P<0.001) in patients with GC. VEGF expression was not associated with OS (HR, 1.25; 95% CI, 0.86-1.82; P=0.24). HER2 expression was still identified as an independent prognostic factor in Stage II-III patients treated with surgery and adjuvant chemotherapy (P=0.004) but not in patients who received surgery alone (P=0.61). Among patients with Stage III GC, those without HER2 expression survived longer with adjuvant chemotherapy (median 43.9 vs 32.2 months, respectively; P=0.04), whereas those with HER2 expression did not (median 37.1 vs 33.9 months, respectively; P=0.67).
HER2 expression is independently associated with OS in GC, especially in patients who are at higher risk and receive adjuvant chemotherapy after curative resection. HER2 expression may have important clinical utility in directing adjuvant treatment for Stage III GC patients.
我们试图确定人表皮生长因子受体2（HER2）和血管内皮生长因子（VEGF）的表达是否为胃癌（GC）的独立预后因素。
2010年10月至2012年12月期间，共有678例接受根治性手术的连续性GC患者，其切除组织采用免疫组织化学法检测HER2和VEGF表达。使用DAKO-HercepTest™分析HER2的免疫组织化学表达，并根据已发表的报告进行评分。VEGF表达通过将阳性细胞百分比得分乘以强度得分来计算。我们将阳性表达定义为1+、2+或3+分，0分定义为阴性表达。我们将这些结果与临床病理特征进行比较，包括总生存期（OS）。
多因素分析显示，HER2表达与GC患者较短的OS独立相关（风险比[HR]，1.55；95%置信区间[CI]，1.10-2.18；P=0.01），且与较高的肿瘤-淋巴结-转移分期独立相关（HR，3.88；95%CI，2.67-5.64；P<0.001）。VEGF表达与OS无关（HR，1.25；95%CI，0.86-1.82；P=0.24）。在接受手术和辅助化疗的II-III期患者中，HER2表达仍被确定为独立的预后因素（P=0.004），但在仅接受手术的患者中并非如此（P=0.61）。在III期GC患者中，未表达HER2的患者接受辅助化疗后生存期更长（分别为43.9个月和32.2个月；P=0.04），而表达HER2的患者则不然（分别为37.1个月和33.9个月；P=0.67）。
HER2表达与GC患者的OS独立相关，尤其是在高风险且根治性切除后接受辅助化疗的患者中。HER2表达在指导III期GC患者的辅助治疗中可能具有重要的临床应用价值。
