人表皮生长因子受体2与晚期食管鳞癌患者含铂类药物化疗预后的相关性

Correlation between Human Epidermal Growth Factor Receptor 2 with Prognoses of Patients with Advanced Esophageal Squamous Cell Carcinoma Undergoing Platinum-based Chemotherapy

目的分析人表皮生长因子受体2(HER2)与晚期食管鳞癌患者含铂类药物化疗预后的相关性。方法回顾性分析2018年6月—2019年6月采用含铂类药物化疗的晚期食管鳞癌100例的临床资料,根据随访2年预后情况分为预后良好组53例和预后不良组47例。收集两组入院时临床资料,对病变组织采用荧光原位杂交技术检测HER2/neu基因扩增情况,采用免疫组织化学法检测HER2蛋白表达情况。应用多因素Logistic回归分析晚期食管鳞癌患者含铂类药物化疗预后不良的危险因素。结果预后良好组浸润深度为T4、淋巴结转移、白蛋白≤35 g/L、HER2蛋白表达阳性及HER2/neu基因扩增阳性患者占比显著低于预后不良组(P<0.05,P<0.01)。经多因素Logistic回归分析,浸润深度为T4、淋巴结转移、白蛋白≤35 g/L、HER2蛋白表达阳性及HER2/neu基因扩增阳性是晚期食管鳞癌患者含铂类药物化疗预后不良的独立危险因素(P<0.01)。结论HER2蛋白表达阳性、基因扩增阳性与晚期食管鳞癌患者含铂类药物化疗预后密切相关,可作为预测预后的重要指标。

Objective To analyze the correlation between human epidermal growth factor receptor 2(HER2)with prognoses of patients with advanced esophageal squamous cell carcinoma(ESCC)undergoing platinum-based chemotherapy(PBCT).Methods A retrospective analysis was performed on clinical data of 100 patients with advanced ESCC undergoing PBCT between June 2018 and June 2019.The patients were divided into good prognosis group(n=53)and poor prognosis group(n=47)based on the prognoses by 2 years of follow-up.Clinical data of all the patients at admission was collected.Fluorescence in situ hybridization was used to detect the amplification of HER2/neu gene in the diseased tissues,and the expression of HER2 protein was determined by immunohistochemistry.Multivariate Logistic regression analysis was used to analyze risk factors for unfavourable prognoses of patients with advanced ESCC using PBCT.Results Proportions of patients with T4 infiltration depth,lymph node metastasis,albumin less than or equal to 35 g/L,positive expression of HER2 protein and positive HER2/neu gene amplification in good prognosis group were significantly lower than those in poor prognosis group(P<0.05,P<0.01).Multivariate Logistic regression analysis showed that T4 infiltration depth,lymph node metastasis,albumin less than or equal to 35 g/L,positive expression of HER2 protein and positive HER2/neu gene amplification were risk factors for poor prognoses of patients with advanced ESCC(P<0.01).Conclusion The positive expression of HER2 protein and positive gene amplification are closely related to prognoses of patients with advanced ESCC undergoing platinum-based chemotherapy,and therefore they may be used as important indicators for predicting prognoses of patients.