Bi Yanzhi, Zhang Junling, Zeng Dongxiang, Chen Lili, Ye Wei, Yang Quanliang, Ling Yang
Department of Oncology, Changzhou Tumor Hospital Affiliated to Soochow University, Changzhou, China.
The Medical Department, 3D Medicines Inc., Shanghai, China.
Pathol Oncol Res. 2021 Mar 25;27:580800. doi: 10.3389/pore.2021.580800. eCollection 2021.
Cholinesterase (CHE) is a routine serum biomarker in gastric cancer (GC). However, little research has been done on its clinical value in advanced GC. In addition, it is not clear whether it can be used as biomarker for the response and prognosis of advanced GC patients. Between Jan. 2013 and Dec. 2016, a total of 150 patients with advanced GC treated with first-line chemotherapy were admitted to Changzhou Tumor Hospital Affiliated to Soochow University. We retrospectively identified serum CHE level on the day before chemotherapy and at the end of chemotherapy and abstracted clinicopathologic features and treatment outcomes. Univariate and multivariate survival analyses were performed to assess the relationship between serum CHE levels and progression-free survival (PFS) and overall survival (OS). A total of 150 advanced GC patients were included and divided into serum level ≥5,000 IU/L and serum level <5,000 IU/L. CHE level lower than 5,000 IU/L was associated with poorer PFS (HR, 1.60; 95% CI, 1.141-2.243; = 0.006), poorer OS (HR, 1.76; 95% CI, 1.228-2.515; = 0.002) and trend of poorer response (HR, 0.56; 95% CI, 0.272-1.129; = 0.104). In univariate and multivariate logistic regression analysis, only liver metastasis and PS score were significantly associated with objective response ( < 0.05). The medium PFS was 8.0 months in patients with post-treatment CHE increased vs. 3.8 months in patients with CHE decreased after chemotherapy (HR, 1.82; 95% CI 1.28-2.57; = 0.0002). The medium OS was 13.1 months in patients with increased post-treatment CHE vs. 8.1 months in patients with decreased post-treatment CHE (HR, 1.87; 95% CI 1.29-2.71; = 0.0002). Advanced GC with CHE levels below 5,000 IU/L was significantly associated with poor PFS and OS. The results suggested that CHE analysis before chemotherapy was a promising prognostic marker for advanced GC.
胆碱酯酶（CHE）是胃癌（GC）的一种常规血清生物标志物。然而，关于其在晚期胃癌中的临床价值的研究较少。此外，尚不清楚它是否可作为晚期胃癌患者反应和预后的生物标志物。2013年1月至2016年12月期间，苏州大学附属常州肿瘤医院共收治了150例接受一线化疗的晚期胃癌患者。我们回顾性确定了化疗前一天和化疗结束时的血清CHE水平，并提取了临床病理特征和治疗结果。进行单因素和多因素生存分析以评估血清CHE水平与无进展生存期（PFS）和总生存期（OS）之间的关系。共纳入150例晚期胃癌患者，分为血清水平≥5000 IU/L组和血清水平<5000 IU/L组。CHE水平低于5000 IU/L与较差的PFS（HR，1.60；95%CI，1.141 - 2.243；P = 0.006）、较差的OS（HR，1.76；95%CI，1.228 - 2.515；P = 0.002）以及较差的反应趋势（HR，0.56；95%CI，0.272 - 1.129；P = 0.104）相关。在单因素和多因素逻辑回归分析中，只有肝转移和PS评分与客观反应显著相关（P < 0.05）。化疗后CHE升高的患者中位PFS为8.0个月，而化疗后CHE降低的患者为3.8个月（HR，1.82；95%CI 1.28 - 2.57；P = 0.0002）。化疗后CHE升高的患者中位OS为13.1个月，而化疗后CHE降低的患者为8.1个月（HR，1.87；95%CI 1.29 - 2.71；P = 0.0002）。CHE水平低于5000 IU/L的晚期胃癌与较差的PFS和OS显著相关。结果表明，化疗前的CHE分析是晚期胃癌一个有前景的预后标志物。
