胃癌组织中Her-2蛋白的过表达与临床病理的相关分析

Correlation Between Overexpression of Her-2 Protein and Clinicopathology in Gastric Cancer

[目的]研究胃癌患者术前胃镜咬检、术后标本组织中人表皮生长因子受体2(Her-2)表达的一致性,探讨术后标本组织中Her-2蛋白的过表达及其与临床病理的关系。[方法]选取前瞻性、多中心、开放、随机对照Ⅲ期临床试验(NCT01516944)中277例直接手术的进展期胃癌患者,采用免疫组织化学法(IHC)检测其术前胃镜活检、术后标本组织Her-2蛋白的表达情况,其中2+和3+认为是Her-2蛋白过表达(简称Her-2的过表达),并分析Her-2过表达与患者性别、年龄、肿瘤部位、Lauren分型、分化程度、浸润深度、淋巴结转移、远处转移、TNM分期、脉管瘤栓、神经受侵的相关性。[结果]277例胃癌患者中术前胃镜咬检组织的Her-2的过表达率为32.85%,其中3+的有23例;术后标本组织的Her-2的过表达率为29.60%,其中3+的有21例,两者差异无统计学意义(P=0.711)。所有术后患者的Her-2过表达与肿瘤分化、浸润深度、淋巴转移、TNM分期等存在明显关系(P<0.05),与患者年龄、性别、肿瘤部位、Lauren分型、远处转移等无明显关系(P>0.05)。[结论]术前胃镜咬检、术后标本组织中Her-2表达基本一致;随着胃癌浸润深度、淋巴转移、TNM分期增加,Her-2蛋白过表达率随之增加,并且Her-2蛋白过表达率在中分化胃癌中所占比例较大。

[Purpose]To analyze the consistency of human epidermal growth factor receptor-2 （Her-2） expression in preoperative gastroscopic biopsy tissues and in postoperative specimens in patients with gastric cancer,and to investigate the relation of Her-2 overexpression in postopera- tive specimens with clinicopathology of gastric cancer . [MethodslTwo hundred and seventy-seven cases of advanced gastric cancer with surgery alone from prospective,multicenter,open,random- ized,controlled II phase clinical trial （NCTO1516944） were enrolled in the study. Her-2 overex- pression in preoperative gastroscopic biopsy tissues and in postoperative specimens was detected by immunohistochemical method （IHC）,and Her-2 expression with 2＋ or 3＋ was considered as overexpression. The relation of Her-2 overexpression with gender, age,tumor location,Lauren classification,differentiation grade,depth of invasion,lymph node metastasis,distant metastasis, TNM stage,vascular invasion,neural invasion was analyzed. [Resuhs]Her-2 overexpression in preoperative gastroscopic biopsy tissues of 277 cases with gastric cancer was 32.85% ,with 3＋ of 23 cases;and that in postoperative specimens was 29.60% ,with 3＋ of 21 cases. There was no significant difference between them （P=0.711）. Her-2 overexpression in postoperative specimens had significant correlation with the grade of differentiation, depth of invasion, lymph node metas- tasis,TNM staging （P〈0.05）,and had no correlation with patient＇ s age,gender,tumor location, Lauren classification, distant metastasis （P〉0.05）. [Conclusions ] Her-2 expression in preoperative gastroscopic biopsy tissues is consistent with that in postoperative specimens. Her-2 overexpres- sion rate increases with the increasing of depth of invasion,lymph node metastasis,and TNM stage, and the overexpression occupies a large proportion in gastric cancer with moderate differ- entiation.