EGFR、HER-2蛋白表达与胃癌病理特征及预后相关性研究

A study on the correlation between the expression of EGFR and HER-2 proteins and the pathological characteristics and prognosis of gas-tric cancer

目的 探讨HER-2、EGFR蛋白表达与胃癌病理特征及预后相关性。方法 回顾性收集本院2019年1月至2023年10月诊断为胃癌并行手术切除的147例患者临床资料。采集患者基线及病理资料,采用免疫组化染色法检测EGFR、HER-2蛋白表达水平。根据EGFR、HER-2蛋白表达水平分别分为高表达组、低表达组,采用χ^(2)检验分析EGFR、HER-2表达与病理特征的关系;采用Pearson相关性分析法分析EGFR、HER-2两者的相关性;使用COX回归分析胃癌患者总生存期(overall Survival,OS)影响因素。结果 147例胃癌患者中EGFR高表达率46.94%(69/147),低表达率53.06%(78/147),HER-2高表达率49.66%(73/147),低表达率50.34%(74/147)。EGFR表达水平与胃癌患者分化程度、是否淋巴结转移、TNM分期、HER-2蛋白表达存在密切关系(P<0.05)。至随访结束,147例胃癌患者共有89例患者达到PFS终点,平均OS为19.47月。EGFR高表达组患者较低表达组患者OS有显著差异(21.36月vs.14.35月)。HER-2表达水平与胃癌患者分化程度、是否淋巴结转移、TNM分期存在密切关系(P<0.05)。至随访结束,HER-2高表达组患者较低表达组患者OS差异有统计学意义(22.45月vs.15.74月,P<0.001)。胃癌患者HER-2与EGFR表达水平呈正相关性(r=0.435,P<0.05)。COX多因素分析显示淋巴结转移[1.535(1.355~1.807)]、HER-2高表达[1.340 (1.206~1.561)]、EGFR高表达[1.481(1.308-1.750)]均为影响胃癌患者OS的独立危险因素(均P<0.05)。结论EGFR、HER-2蛋白表达预测胃癌患者预后有着潜在价值,两者之间存在密切关系,且EGFR、HER-2高表达水平与不良预后密切相关。

Objective To explore the correlation between HER-2 and EGFR protein expression and pathological characteristics and prognosis of gastric cancer.Methods The clinical data of 147 patients diagnosed with gastric cancer and underwent surgical resection in our hospital from January 2021 to October 2023 were retrospectively collected,includingpatient baseline,pathological data,and expression levels of EGFR and HER-2proteins detectted by immunohistochemical staining.According to the expression levels of EGFR and HER-2,they were divided into high expression group and low expression group.the relationship between the expression of EGFR and HER-2 and pathological features was evaluated by χ^(2)analysis.The correlation between EGFR and HER-2 was analyzed using Pearson correlation analysis.The influencing factors of overall survival(OS) in gastric cancer patients was analyzed using COX regression.Results Among 147 gastric cancer patients,the high expression rate of EGFR was 46.94%(69/147),the low expression rate was 53.06%(78/147),the high expression rate of HER-2 was 49.66%(73/147),and the low expression rate was 50.34%(74/147).The expression level of EGFR was closely related to the degree of differentiation,lymph node metastasis,TNM staging and HER-2 protein expression in gastric cancer patients(P<0.05).At the end of follow-up,89 gastric cancer patients reached the PFS endpoint,with an average OS of19.47 months.There was a significant difference in OS between patients with high EGFR expression and those with low EGFR expression(21.36months vs.14.35 months).The expression level of HER-2 was closely related to the degree of differentiation,lymph node metastasis and TNM staging in gastric cancer patients(P<0.05).At the end of follow-up,there was a significant difference in OS between patients with high HER-2 expression and those with low HER-2 expression(22.45 months vs.15.74 months,P<0.001).There was a positive correlation between HER-2 and EGFR expression levels in gastric cancer patients(r=0.435,P<0.05).COX multivariate analysis showed that lymph node metastasis [1.535(1.355-1.807)],high HER-2 expression [1.340(1.206-1.561)],and high EGFR expression [1.481(1.308-1.750)] were all independent risk factors affecting OS in gastric cancer patients(all P<0.05).Conclusion The expression of EGFR and HER-2 proteins has potential value in predicting the prognosis of gastric cancer patients.The high expression levels of EGFR and HER-2 proteins are closely related to poor prognosis.