胃癌伴神经内分泌分化HER-2基因扩增和蛋白表达及预后分析

Roles of HER-2 gene amplification and protein expression in gastric carcinoma with neuroendocrine differentiation

目的观察胃癌伴神经内分泌分化(NED)和胃癌中HER-2基因扩增及蛋白表达情况。方法回顾性分析胃癌伴神经内分泌分化患者70例和具有相同分期的胃癌患者150例,采用免疫组化法(IHC)联合双色银染色素原位杂交(DISH)检测胃癌伴NED和胃癌中HER-2基因扩增和蛋白表达情况,并对胃癌伴NED进行预后分析。结果胃癌伴NED和胃癌中HER-2蛋白过表达率分别为20.00%和21.33%,HER-2基因扩增率分别为8.57%和14.67%。HER-2蛋白表达、HER-2基因扩增及基因扩增类型2组间差异均无统计学意义;胃癌伴NED17号染色体多体与HER-2基因扩增呈正相关。胃癌伴NED患者中HER-2基因扩增者术后生存期短于HER基因不扩增者。多因素分析显示胃癌伴或不伴NED、HER-2基因是否扩增、淋巴结转移和手术方式是预后的独立影响因素。结论胃癌伴NED属于胃癌特殊类型,其HER-2基因扩增、蛋白表达情况和胃癌相同,HER-2基因扩增的胃癌伴NED患者预后差。

Objective To evaluate the gene amplification and protein expression of HER-2 in gastric carcinoma with or without neuroendocrine differentiation （NED）, and to explore the difference in HER-2 gene profile between these two neo？plasms. Methods Cases of gastric carcinoma with NED （n=70） and cases of gastric carcinoma without NED （n=150） were retrospectively reviewed. Gene amplification and protein expression of HER-2 genes in gastric carcinoma with or without NED were detected by combination of immunohistochemical method （IHC） and double color silver dye for in situ hybridiza？tion （DISH）. Prognosis of gastric cancer patients with NED were predicted using Kaplan-Meiers survival analysis. Results Expression rates of HER-2 in gastric cancer with and without NED are 20.00%and 21.33%respectively. Amplification of HER-2 in gastric cancer with and without NED are 8.57%and 14.67%respectively. Gene amplification and protein expres？sion of HER-2 between gastric cancer with NED and without NED showed no statistical difference. Chromosome 17 multi-body positively correlated with gene HER-2 amplification in Gastric carcinoma with NED. Postoperative survival period in patients of gastric carcinoma with NED and HER-2 amplification was shorter than that in patients of gastric carcinoma with？out NED but with HER-2 amplification. Gastric carcinoma with or without NED, HER-2 gene amplification, lymph node me？tastasis and operation method obviously correlate with prognosis of gastric carcinoma patients （P＆lt;0.05）. Conclusion The gastric cancer with NED is a special type of gastric cancer, there was no difference of gene amplification and protein expres？sion of HER-2 gene between gastric carcinoma with NED and without NED. Poor prognosis would be expected in gastric can？cer patients with NED and HER-2 amplification.