HER2表达及肿瘤标志物水平与老年胃癌患者预后的关系

Relationship of Human Epidermal Growth Factor Receptor 2 and Tumor Markers with Prognosis in Older Patients with Advanced Gastric Cancer

目的 探讨人表皮生长因子2(HER2)及肿瘤标志物血清糖类抗原125(CA125)、糖类抗原724(CA724)、糖类抗原199(CA199)、糖类抗原242(CA242)及癌胚抗原(CEA)在老年晚期胃癌患者中的表达及其与胃癌预后的关系。方法 选取2014~2018年于南京大学医学院附属鼓楼医院收治的234例老年晚期胃癌患者作为研究对象,收集临床资料及首次入院时肿瘤标志物CEA、CA125、CA242、CA199、CA724的结果,采用免疫组化方法,检测胃癌组织中HER2表达水平,分析HER2及肿瘤标志物与老年胃癌患者预后的相关性。结果 单因素分析结果显示,肿瘤部位、有无腹腔转移、有无原位复发、CEA、CA199、CA125、HER2表达是影响老年晚期胃癌患者预后的重要因素(P<0.05)。多因素Cox回归模型显示,CA125阳性是影响老年晚期胃癌患者预后的独立危险因素(P<0.05),HER2阴性表达是影响老年晚期胃癌患者预后的保护因素(P<0.05)。结论 老年晚期胃癌患者有其特殊性,肿瘤标志物CA125及HER2表达可作预后的参考指标。

Objective To investigate the expression of human epidermal growth factor receptor 2(HER2),carbohydrate antigen(CA)125,CA724,CA199,CA242,and carcinoembryonic antigen(CEA) in older patients with advanced gastric cancer, and their relationship with prognosis.Methods A total of 234 older patients with advanced gastric cancer treated in Drum Towel Hospital Affiliated to Nanjing University Medical School from 2014 to 2018 were enrolled.The clinical data and the expression of CEA,CA125,CA242,CA199 and CA724 at the first admission were recorded.Immunohistochemical staining was used to detect the expression of HER2 in tumor tissues.The correlation of HER2 and tumor markers with prognosis was analyzed.Results Univariate analysis showed that tumor location, abdominal metastasis, in situ recurrence, the expression of CEA,CA199,CA125,and HER2 were important factors for prognosis in older patients with advanced gastric cancer(P<0.05).Multivariate Cox regression model showed that the positive expression of CA125 was an independent risk factor for prognosis in older patients with advanced gastric cancer(P<0.05),and the negative expression of HER2 was a protective factor(P<0.05).Conclusion Older patients with advanced gastric cancer have their own particularities, and CA125 and HER2 may be used to estimate prognosis.