Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Pathology Gastroscopy, Pingxiang General Hospital, Pingxiang, Xingtai, China.
Pathol Res Pract. 2021 Jan;217:153280. doi: 10.1016/j.prp.2020.153280. Epub 2020 Nov 5.
Her2-positive gastric cancer is a unique subtype of disease, requiring different diagnosis and treatment strategies and methods. Neoplasms are significantly correlated with the occurrence, invasion and metastasis of tumors. The purpose of this study was to explore the correlation between HER2 amplification and tumor interstitial angiogenesis in patients with gastric cancer.
The data of 1121 patients with gastric cancer were retrospectively analyzed, and the amplification of HER2 was detected by immunohistochemistry (IHC) and FISH. CD34 IHC was used to label MVD. We analyzed the factors affecting HER2 amplification, the difference in MVD under different HER2 states, the factors related to 5-year survival rate of patients, and predicted the independent factors affecting 5-year survival rate of gastric cancer patients.
We found 115 cases with HER2 positive rate of 10.26 %. HER2 amplification was more likely in gastric cancer patients with more than 5.2 cm tumor diameter, Lauren intestinal type, tubular adenocarcinoma, and the depth of infiltration at stage T2, (P < 0.05). Gender, age, tumor location, number of lymph node metastasis, distant metastasis, clinical stage, nerve invasion and vascular tumor thrombi were not the factors affecting HER2 amplification of gastric cancer (P > 0.05). MVD count of HER2-positive gastric cancer was significantly higher than that of HER2-negative gastric cancer, (P < 0.05). The 5-year overall survival rate of 1121 patients with gastric cancer was 51.92 %. HER2 amplification, high MVD count, large tumor size, tubular adenocarcinoma, Lauren intestinal type, deep tumor infiltration, numerous lymph node metastases and late clinical stage are all associated with low 5-year survival rate, indicating poor prognosis in gastric cancer patients, (P < 0.05). The 5-year survival rate of gastric cancer patients was not correlated with gender, age, tumor location, distant metastasis, nerve invasion and vascular cancer plug, (P > 0.05). Multivariate analysis showed that Lauren classification, Infiltrating depth, Nodal status, Clinical stage, HER2 expression, MVD count were independent factors affecting the prognosis of gastric cancer patients, (P < 0.05).
HER2 overexpression was not only closely related to gastric cancer neovascularization, but also an independent predictor of prognosis of gastric cancer. In clinical treatment, anti-HER2 targeted therapy and anti-angiogenesis drugs can be adopted to achieve effective treatment.
人表皮生长因子受体 2(HER2)阳性胃癌是一种独特的疾病亚型,需要不同的诊断和治疗策略及方法。肿瘤与肿瘤的发生、浸润和转移密切相关。本研究旨在探讨胃癌患者 HER2 扩增与肿瘤间质血管生成的相关性。
回顾性分析 1121 例胃癌患者的临床资料,采用免疫组化(IHC)和荧光原位杂交(FISH)检测 HER2 扩增情况,采用 CD34 IHC 标记 MVD。分析影响 HER2 扩增的因素、不同 HER2 状态下 MVD 的差异、与患者 5 年生存率相关的因素,并预测影响胃癌患者 5 年生存率的独立因素。
HER2 阳性率为 10.26%。HER2 扩增与肿瘤直径大于 5.2cm、Lauren 肠型、管状腺癌、T2 期浸润深度相关(P<0.05)。性别、年龄、肿瘤部位、淋巴结转移数、远处转移、临床分期、神经浸润和血管癌栓不是影响胃癌 HER2 扩增的因素(P>0.05)。HER2 阳性胃癌的 MVD 计数明显高于 HER2 阴性胃癌(P<0.05)。1121 例胃癌患者 5 年总生存率为 51.92%。HER2 扩增、高 MVD 计数、肿瘤体积大、管状腺癌、Lauren 肠型、浸润深度深、淋巴结转移多、临床分期晚均与 5 年生存率低相关,提示胃癌患者预后不良(P<0.05)。胃癌患者 5 年生存率与性别、年龄、肿瘤部位、远处转移、神经浸润和血管癌栓无相关性(P>0.05)。多因素分析显示,Lauren 分型、浸润深度、淋巴结状态、临床分期、HER2 表达、MVD 计数是影响胃癌患者预后的独立因素(P<0.05)。
HER2 过表达不仅与胃癌新生血管密切相关,而且是胃癌预后的独立预测因子。在临床治疗中,可以采用抗 HER2 靶向治疗和抗血管生成药物进行有效治疗。