EGFR、HER-2/neu蛋白在胃癌中的表达及其预后价值研究

Studies on the expressions of FGFR and HER-2/neu in gastric cancer and their prognostic value

目的研究胃癌组织中表皮生长因子受体(EGFR)、HER-2/neu蛋白的表达与临床病理特征及生存时间的关系,探讨其作为胃癌预后指标的可行性。方法应用免疫组织化学法检测103例胃癌标本中EGFR、HER-2/neu蛋白的表达,并将检测结果与患者临床病理特征进行综合分析。结果在103例胃癌组织中,EGFR、HER-2/neu蛋白的阳性表达率分别为42.7%(44/103)、31.1%(32/103),而胃正常组织中均无表达。EGFR、HER-2/neu蛋白表达与患者的性别、年龄、肿瘤大小、部位、分化程度均无相关性(P>0.05),而与肿瘤的浸润深度、病理分期、淋巴结转移、远处转移相关(P<0.05)。EGFR、HER-2/neu蛋白表达阳性患者的中位生存时间分别为11.0和10.1个月,表达阴性患者的中位生存时间分别为65.2和64.5个月,表达阳性与阴性患者的生存时间有显著性差异(P<0.05)。EGFR与HER-2/neu蛋白联合表达与生存时间相关(P_(EGFR)=0.027,P_(HER-2/neu)=0.000,r_(EGFR)=1.965,r_(HER-2/neu)= 3.153),二者阳性表达时有减少胃癌患者生存时间的危险,HER-2/neu阳性表达的危险度相对较大。结论测定胃癌组织中EGFR、HER-2/neu蛋白的表达,有助于判断患者预后,也为分子靶向治疗药物在胃癌的应用提供了理论依据。

Objective To investigate the expressions of epidermal growth factor receptor （EGFR） and HER-2/neu protein in gastric cancer, and their relationship with pathologic features and survival time, and to discuss the feasibility of EGFR and HER-2/neu as prognostic markers. Methods 10a samples of gastric cancer were studied by immunohistochemical technique to detect the expressions of EGFR and HER-2/neu in those specimens, and the findings were then comprehensively analyzed in collaboration with pathological changes and their follow-up data. Results The positive expression of EGFR was detected in 44 of 103 gastric cancer specimens （42. 7%）, the positive expression of HER-2/neu was found in ag of 103 gastric cancer specimens （31. 1%）, while neither the EGFR nor the HER-2/neu was expressed in normal gastric tissue. No correlation existed between their expressions in neoplastic tissues with sex, age, size and site of tumor and the degree of differentiation （P〉0. 05）. The expressive rates of both EGFR and HER-2/neu were related to the depth of invasion, the clinical stage, lymph node metastasis, distant metastasis and the survival time of patients （P〈0.05）. The median survival time of patients with positive expression of EGFR and HER-2/neu was 11.0 and 10. 1 months, respectively, while the median survival time of patients with negative expression of EGFR and HER-2/neu was 65. 2 and 64. 5 months, respectively. There existed significant difference on the survival time between the patients with or without EGFR expression （P〈0.05）. The combined expression of both EGFR and HER-2/neu was correlated to the survival time of patients （PEGFR =0. 027, P-2/neu =0. 000, rEGFR=1. 965, rHER-2/neu=3. 153）. Positive expressions might herald a short survival time, and the positive expression of HER-2/neu might be even more predictive. Conclusion Determination of the expression of EGFR and HER-2/neu in gastric cancer tissues may be helpful to determine the prognosis, guide the treatment for the patients, and help establish a theoretical basis for the clinical application of molecular targeted drugs, such as IMC-C225 and Herceptin.