中国胃癌患者HER2蛋白表达与临床病理学参数及预后的关系

Association of HER2 protein expression with clinicopathologic features and prognosis in Chinese patients with gastric carcinoma

目的 评估中国胃癌人群中HEB2蛋白表达的流行病学情况,分析其与患者临床病理学参数之间的关系,探讨HEB2蛋白表达与胃癌患者预后的关系.方法 使用免疫组织化学方法检测胃癌患者中HER2蛋白的表达,以修订后HereepTest评分标准进行评分.x2检验分析HEB2蛋白表达与胃癌患者临床病理学参数之间的关系.生存分析应用Kaplan-Meier法,生存率比较采用Logrank 检验.结果 860例患者中位年龄59岁,男女比例为2.06∶1,其中进展期胃癌患者为774例.使用修订后的HercpTest评分标准评判HER2蛋白阳性表达（3＋）的患者为77例（9.0%,77/860）,其中进展期胃癌中的HER2阳性表达患者是69例,占进展期胃癌的8.9%（69/774）.HEB2蛋白在胃癌中的阳性表达与肿瘤分化、Lauren分型及WHO分型相关,与年龄、性别、肿瘤发生部位及临床分期不相关.生存分析提示HER2蛋白阳性表达的胃癌患者生存率与阴性表达者无明显差异.结论 虽然胃癌HER2蛋白的阳性表达与肿瘤分化及组织学类型相关,但其可能不是胃癌患者的独立预后因子;HER2蛋白在胃癌中的阳性表达可能不影响胃癌患者的预后.

Objective To evaluate the epidemiological status of HER2 protein expression in Chinese patients with gastric carcinoma,and to study its clinical and prognostic significance and the association with the clinicopathological features.Methods The clinical data were reviewed in 860 patients with gastric carcinoma admitted to Guangdong General Hospital from 2003 to 2010.The HER2 status Was evaluated using immunohistochemistry（IHC）.The modified Heroep Test scoring criterion Was used to assess HER2 protein expression.The association between HER2 expression and clinicopathological features was analyzed by X2 test.Kaplan-Meier analysis,log-rank test and Cox regression model were used for the survival analysis.Results The median age of the patients Was 59 years, and the male-to-female ratio was 2.06∶1.Positive expression of HER2 protein（3＋）was found in 77（9.0%）cases of gastric carcinoma,and in 69（8.9%）edvanced gastric cancers.There waS significantly positive association between HER2 overexpression and tumor differentiation, Lanren claasification and WHO classification.No significant association Was observed between HER2 protein expression and patients＇age,gender,tumor location and clinical stage.There waS no statistically significant difference in survival rate between patients with positive HER2expression and negative ones. Conclusion Though there WaS significantly positive association between HER2 expression status and tumor differentiation,histological type,it may be of limited prognostic value in gastric cancer patients.