Li Guo-Cai, Jia Xu-Chun, Zhao Qing-Chuan, Zhang Hong-Wei, Yang Peng, Xu Long-Long, Pang Fang-Ning, Sun Jian-Bing
Division of Digestive Surgery, Hospital of Digestive Diseases, Xi'an International Medical Centre.
Division of Pathology.
Medicine (Baltimore). 2020 May 22;99(21):e20460. doi: 10.1097/MD.0000000000020460.
To investigate the different expression of epidermal growth factor receptor 1 (EGFR) and human epidermal growth factor receptor 2 (HER2) in gastric cancer based on tumor locations and its impact on patients survival.Gastric cancer is heterogeneous disease, recent years have established a molecular classification and described distribution of molecular subtypes in stomach. However, the difference of EGFR and HER-2 expression among tumor location is still unknown.Between January 2010 and August 2014, 2477 consecutive patients with gastric cancer were treated in our surgery department. The tumor locations were classified into 4 groups: cardia, fundus, corpus, and antrum. Based on tumor locations, the clinicopathologic characteristics, EGFR and HER-2 expression, and follow-up data were analyzed by univariant analysis and Kaplan-Meier analysis retrospectively.There were difference of gender, age, Borrmann type, pathological type, differentiation, T-stage, tumor size, gastrectomy method, and complications among the locations. The positive rate of EGFR expression in fundus was 18.18%, which was lower than cardia (46.21%), corpus (43.62%), and antrum (48.83%) (P < .001). The 5-year survival rate in EGFR positive patients was 50.8%, which was significantly lower than EGFR negative patients (64.0%, P = .021). The positive rate of HER-2 expression in cardia was 48.15%, which was significantly higher than fundus (37.5%), corpus (35.45%), and antrum (38.54%) (P = .009), but HER-2 expression did not correlate with 5-year survive (P = .548).Our results suggest that there exist difference of EGFR and HER-2 expression based on tumor locations, and the distribution of EGFR impact on patients survival. Emphasizing the role of EGFR and HER-2 in the context of location contribute to make appropriate treatment strategy and improve prognosis of gastric cancer.
基于肿瘤位置研究表皮生长因子受体1(EGFR)和人表皮生长因子受体2(HER2)在胃癌中的表达差异及其对患者生存的影响。胃癌是一种异质性疾病,近年来已建立了分子分类并描述了胃中分子亚型的分布。然而,肿瘤位置之间EGFR和HER-2表达的差异仍不清楚。2010年1月至2014年8月,我科连续收治2477例胃癌患者。肿瘤位置分为4组:贲门、胃底、胃体和胃窦。基于肿瘤位置,回顾性地通过单因素分析和Kaplan-Meier分析对临床病理特征、EGFR和HER-2表达以及随访数据进行分析。各位置之间在性别、年龄、Borrmann分型、病理类型、分化程度、T分期、肿瘤大小、胃切除方法及并发症方面存在差异。胃底EGFR表达阳性率为18.18%,低于贲门(46.21%)、胃体(43.62%)和胃窦(48.83%)(P<0.001)。EGFR阳性患者的5年生存率为50.8%,显著低于EGFR阴性患者(64.0%,P=0.021)。贲门HER-2表达阳性率为48.15%,显著高于胃底(37.5%)、胃体(35.45%)和胃窦(38.54%)(P=0.009),但HER-2表达与5年生存率无关(P=0.548)。我们的结果表明,基于肿瘤位置EGFR和HER-2表达存在差异,且EGFR的分布影响患者生存。强调EGFR和HER-2在肿瘤位置背景下的作用有助于制定合适的治疗策略并改善胃癌预后。