早期胃腺癌辅助放化疗的预后生物标志物。
Prognostic Biomarkers in Early-stage Gastric Adenocarcinoma Treated With Adjuvant Chemoradiotherapy.
机构信息
Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, U.S.A.
Second Department of Internal Medicine, Propaedeutic, Oncology Section, National and Kapodistrian University of Athens, University General Hospital Attikon, Athens, Greece.
出版信息
Cancer Genomics Proteomics. 2020 May-Jun;17(3):277-290. doi: 10.21873/cgp.20188.
BACKGROUND/AIM: Early-stage gastric cancer has a high risk of recurrence, despite trimodality therapy with surgery, chemotherapy and radiation. To improve patient selection for adjuvant chemoradiotherapy, we evaluated the prognostic significance of immunohistochemical and genetic biomarkers in patients with resected gastric adenocarcinoma.
PATIENTS AND METHODS
Tumors from 119 patients were subjected to immunohistochemistry for 12 protein biomarkers, as well as next-generation sequencing. Clinical and biomarker data were available for 91 patients.
RESULTS
EBV-positive tumors and tumors with mutations had higher intratumoral CD8 tumor-infiltrating lymphocyte density (p=0.009 and p=0.017, respectively). PIK3CA mutations were correlated with VEGFA overexpression (p=0.042), while KRAS mutations and HER2 expression were mutually exclusive (p=0.036). PTEN expression univariately confirmed longer overall survival (HR=0.27; p=0.046), while there was a trend between the presence of KRAS mutations and inferior disease-free and overall survival.
CONCLUSION
PTEN protein expression and KRAS mutations may predict disease outcome in early-stage gastric cancer. These results need to be further validated in larger cohorts.
背景/目的：尽管采用手术、化疗和放疗的三联疗法，早期胃癌仍有很高的复发风险。为了改善辅助放化疗患者的选择，我们评估了免疫组织化学和遗传生物标志物在接受胃腺癌切除的患者中的预后意义。
患者和方法
对 119 名患者的肿瘤进行了 12 种蛋白标志物的免疫组织化学检测，并进行了下一代测序。91 名患者的临床和生物标志物数据可用。
结果
EBV 阳性肿瘤和具有突变的肿瘤具有更高的肿瘤内 CD8 肿瘤浸润淋巴细胞密度（p=0.009 和 p=0.017）。PIK3CA 突变与 VEGFA 过表达相关（p=0.042），而 KRAS 突变和 HER2 表达相互排斥（p=0.036）。PTEN 表达单独证实了更长的总生存期（HR=0.27；p=0.046），而 KRAS 突变的存在与无病生存期和总生存期的下降呈趋势相关。
结论
PTEN 蛋白表达和 KRAS 突变可能预测早期胃癌的疾病结局。这些结果需要在更大的队列中进一步验证。
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