摘要
目的 探讨胃癌相关因子表皮生长因子受体（EGFR）、人类表皮生长因子受体2（HER2）、Ki-67及P53在进展期胃癌新辅助化疗疗效中的预测价值.方法 回顾性分析沧州市中心医院2009年8月～2012年8月行新辅助化疗（紫杉醇、顺铂加替加氟）的进展期（Ⅲ期）胃癌患者104例,采用免疫组织化学方法检测肿瘤组织中EGFR、HER2、Ki-67、P53的表达情况,并应用RECIST 1.1标准和病理组织学相结合做化疗疗效评估,Logistic多因素回归分析各指标与化疗疗效的关系.结果 本研究患者新辅助化疗总有效率为54.8％（57/104）,全部为部分缓解.疾病稳定占42.3％（44/104）,疾病进展占2.8％（3/104）.新辅助化疗前后各因子表达差异无统计学意义（P＞ 0.05）.HER2阳性表达者化疗有效率为85.7％（12/14）,阴性表达者化疗有效率为50.0％（45/90）,两者比较差异有统计学意义（P=0.01）.P53阳性表达者化疗有效率为33.9％（19/56）,明显低于阴性表达者的79.2％（38/48）,差异有高度统计学意义（P＜0.01）.HER2阳性表达同时P53阴性表达者6例,其中化疗有效5例.EGFR和Ki-67的表达与化疗敏感性无关（P＞0.05）.多因素分析显示,HER2和P53是新辅助化疗的独立影响因素（P＜0.05）.结论 HER2和P53作为新辅助化疗的独立影响因子,可在化疗前对疗效进行预测,可能对患者新辅助化疗的选择提供临床依据.
Objective To investigate the predictive value of the gastric cancer-associated factors of EGFR,HER2,Ki-67 and P53 on neoadjuvant chemotherapy in patients with advanced gastric cancer.Methods Retrospective analysis was carried out in 104 patients with advanced gastric cancer who were treated on neoadjuvant chemotherapy from August 2009 to August 2012 in Cangzhou Central Hospital.Expressions of HER2,Ki-67 and P53 were detected by immunohistochemistry in gastric cancer tissues before and after neoadjuvant chemotherapy.Chemotherapy efficacy was evaluated according to RECIST 1.1 standard combined with histopathology,and the relationship between various genes and chemotherapy efficacy was analyzed by multivariate Logistic regression analyses.Results The clinical response rate was 54.8% （57/104） in neoadjuvant chemotherapy,and all were partial response.Stable disease rate was 42.3% （44/104） and progressive disease rate was 2.8% （3/104）.The difference of expressions of all the genes before and after neoadjuvant hemotherapy was not statistically significant （P 〉 0.05）.Neoadjuvant chemotherapy efficacy was 85.7% （12/14） in the patients of HER2 positive expression and 50.0% （45/90） in the negative expression,the former was higher than the latter,the differences were statistically significant （P =0.01）.The response rate of P53 in the positive expression patients was 33.9% （19/56） and in negative expression was 79.2% （38/48）,the differences were statistically significant （P〈 0.01）.6 patients with both HER2 positive expression and P53 negative expression were found,5 effective patients with chemotherapy were found.The expressions of EGFR and Ki-67 were not associated with the response to neoadjuvant chemotherapy （P 〉 0.05）.HER2 and P53 were independent influencing factors of neoadjuvant chemotherapy according to multivariate Logistic regression analyzes （P 〈 0.05）.Conclusion As the independent predictive factors,the expressions of HER2 and P53 have great value in the prediction of neoadjuvant chemotherapy efficacy before chemotherapy.
出处
《中国医药导报》
CAS
2014年第2期35-38,共4页
China Medical Herald
