Neves Filho Eduardo Henrique Cunha, Pires Adriana Pinheiro Bezerra, de Sant'Ana Rosane Oliveira, Rabenhorst Silvia Helena Barem, Hirth Carlos Gustavo, da Cunha Maria Do Perpétuo Socorro Saldanha
Division of Pathology, Instituto do Câncer do Ceará, Fortaleza, CE, Brazil.
Universidade de Fortaleza, Fortaleza, CE, Brazil.
APMIS. 2018 May;126(5):389-395. doi: 10.1111/apm.12840.
Although the introduction of the perioperative chemotherapy on the management of gastric cancer has improved patients survival, heterogeneity of clinical outcomes has been evidenced in parallel to different histopathological regression pattern of gastric cancer cells. Thus, this study evaluated the tumor regression grading (TRG) in a series of post-treatment gastric tumors and its associations with HER2, MET, and FOXP3 expression. Material of 54 gastric cancer samples was available for TRG evaluation and immunohistochemistry. We found that total and subtotal pathologic response were significantly associated to the intestinal subtype (p = 0.04) and that well-differentiated tumors were significantly correlated with total or partial response (p = 0.019). Although not associated with the TRG, FOXP3 expression in gastric tumors was associated to poorly differentiated tumors (p = 0.03), to the diffuse and mixed subtypes together (p = 0.04) and to the presence of vascular infiltration (p = 0.04), while HER2 overexpression was associated to better differentiated cases (p = 0.04) and to the absence of vascular infiltration (p = 0.02). MET expression, however, showed no association with the analyzed clinicopathological factors. This study highlights the role of tissue differentiation on pathological response to neoadjuvant chemotherapy in gastric cancer and shows no impact between FOXP3, HER2 and MET expression in terms of TRG.
尽管围手术期化疗应用于胃癌治疗后患者生存率有所提高,但随着胃癌细胞不同的组织病理学消退模式,临床结果的异质性也得到了证实。因此,本研究评估了一系列治疗后胃肿瘤的肿瘤消退分级(TRG)及其与HER2、MET和FOXP3表达的相关性。54例胃癌样本材料可用于TRG评估和免疫组织化学检测。我们发现,完全和不完全病理反应与肠型显著相关(p = 0.04),高分化肿瘤与完全或部分反应显著相关(p = 0.019)。虽然FOXP3在胃肿瘤中的表达与TRG无关,但与低分化肿瘤相关(p = 0.03),与弥漫型和混合型共同相关(p = 0.04),与血管浸润的存在相关(p = 0.04),而HER2过表达与高分化病例相关(p = 0.04),与无血管浸润相关(p = 0.02)。然而,MET表达与所分析的临床病理因素无关。本研究强调了组织分化在胃癌新辅助化疗病理反应中的作用,并且在TRG方面未显示FOXP3、HER2和MET表达之间存在影响。