C-met、表皮生长因子受体、人表皮生长因子受体-2水平与晚期胃癌化疗疗效及患者预后的关系

Relationship between level of C-met,epidermal growth factor receptor,human epidermal growth factor receptor-2 and chemotherapy efficacy and prognosis in patients with advanced gastric cancer

目的探讨胃癌组织中C-met、表皮生长因子受体(epidermal growth factor receptor,EGFR)、人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)水平与胃癌患者化疗效果及预后的关系。方法选取河北省保定市第一中心医院2005年9月至2010年9月经病理确诊的晚期胃癌患者80例。采用SP法检测C-met、EGFR、HER-2蛋白在胃癌组织中的表达,采用COX回归模型探讨C-met、EGFR、HER-2表达与胃癌患者预后的关系。结果 80例患者病情完全缓解3例,部分缓解31例,病情稳定34例,病情进展12例,有效率(response rate,RR)为42.5%,C-met阳性表达29例,阴性51例;EGFR阳性34例、阴性46例;HER-2阳性32例、阴性48例,出现终点事件的患者17例。C-met、EGFR、HER-2表达为阳性的患者化疗有效率明显要低于阴性患者,差异具有显著性(P<0.05)。多因素分析提示:N分期(P=0.002)、EGFR阳性(P=0.04)、C-met阳性(P=0.02)是胃癌患者死亡、转移或复发的独立危险因素。结论 C-met、EGFR、HER-2阳性表达患者化疗疗效差,C-met、EGFR阳性是患者预后差的独立风险因素。

Objective To investigate the relationship between C-met, epidermal growth factor receptor（EGFR）, human epidermal growth factor receptor-2（HER-2） gene expression level and chemotherapy efficacy and prognosis in patients with advanced gastric cancer. Method The clinical date of 80 patients who diagnosed with gastric cancer from September 2005 to September 2010 in Baoding First Central Hospital in Hebei was retrospective analyzed. The expression of C-met, EGFR and HER-2 protein in gastric carcinoma was detected by SP method, and the relationship between the expression level of each protein and the effect of chemotherapy on gastric cancer was discussed. Multivariate analysis was performed using COX proportional hazard regression model in forward stepwise. Result There were 3 cases complete response, 31 cases partial response, 34 cases stable disease, 12 cases progressive disease, 42.5% response rate, 17 cases occurred end point events. The effective rate of the patient which have a positive expression of C-met, EGFR and HER-2 is significantly lower than the negative patients（P〈0.05）.The N stage, C-met, and EGFR were the independent risk factors of metastasis or recurrence. Conclusion C-met, EGFR, HR-2 positive expression patients with a poor chemotherapy efficiency, C-met, EGFR positive is an independent risk factor for patients with poor prognosis.