IGF-1R的表达与XELOX方案化疗治疗晚期胃癌的临床疗效的相关性分析

Correlative Analysis of the Expression of IGF-1R with the Therapeutic Efficacy of XELOX Regimenn for Advanced Gastric Cancer

目的:探讨晚期胃癌患者中胰岛素样生长因子1型受体(IGF-1R)的表达与卡培他滨联合奥沙利铂(XELOX)方案化疗疗效的关系。方法:收集56例一线接受XELOX化疗的晚期胃癌患者的临床、病理资料,采用免疫组化法检测其IGF-1R的表达情况,计算客观有效率(ORR)和疾病控制率(DCR),统计分析IGF-1R的表达与胃癌患者临床病理特征、近期疗效、临床受益率及毒副反应发生情况的关系。结果:56例患者中,IGF-1R的阳性率为69.6%,其中未分化-低分化腺癌患者IGF-1R的阳性率显著高于中-高分化腺癌(76.5%vs.59.1%,P<0.05)。56例患者的ORR为28.6%,DCR为55.3%。与IGF-1R(-)的胃癌患者相比,IGF-1R(+)的胃癌患者ORR、DCR及临床受益率均显著降低(ORR:23.1%vs.41.1%;DCR:48.7%vs.70.5%;临床受益率:51.3%vs.70.6%)(P<0.05)。IGF-1R的表达与XELOX方案所致化疗毒副反应无显著相关性(P>0.05)。结论:IGF-1R的表达可能成为预测胃癌化疗疗效及预后的新指标,IGF-1R(-)的胃癌患者可能更能从XELOX化疗方案中获益。

Objective： To investigate the correlation of insulin-like growth factor type 1 receptor（IGF-1R） expression with the efficacy of capecitabine/ oxaliplatin（XELOX） for advanced gastric cancer. Methods： 56 patients with advanced gastric cancer who were treated with XELOX as first line therapy were enrolled in the present study, and the clinical data and pathological samples were collected.The expression of IGF-1R was detected by immunohistochemical staining. The objective response rate（ORR） and disease response rate（DCR） were calculated. The correlation of IGF-1R expression, clinical data, therapeutic efficacy, clinical benefit response and adverse reactions were analyzed. Results： The positive rate of IGF-1R in the total 56 patients was 69.6%, and the positive rate was significantly higher in patients with un-differentiated/ poorly-differentiated cancer than that with middle to highly differentiated gastric cancer（P〈0.05）. Total ORR and DCR were 28.6% and 55.3%, respectively. ORR and DCR of patients with positive IGF-1R were significantly lower than that of patients with negative IGF-1R expression（ORR： 23.1% vs. 41.1%, DCR： 48.7% vs. 70.5%, P〈0.05）. The clinical benefit response rate was also remarkably decreased in IGF-1R positive patients（51.3% vs. 70.6%,P〈 0.05）. No significant correlation was detected between IGF-1R expression and the incidence of XELOX regimen induced adverse reactions. Conclusions： Patients with negative IGF-1R might benefit more from XELOX therapy, and IGF-1R expression might become a novel predictor of the therapeutic efficacy and prognosis of advanced gastric cancer.