中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
3期
276-280
,共5页
胃肿瘤%新辅助化疗%预测因子
胃腫瘤%新輔助化療%預測因子
위종류%신보조화료%예측인자
Stomach neoplasms%Neoadjuvant chemotherapy%Predictor
目的 探讨7种胃癌相关因子在mFOLFOX7方案新辅助化疗治疗进展期胃癌疗效中的预测价值.方法 选取2009年8月至2011年8月间收治的53例行mFOXFOL7方案(氟尿嘧啶、奥沙利铂加亚叶酸钙)新辅助化疗的Ⅱ～Ⅲ期胃癌病例,采用免疫组织化学方法检测肿瘤组织中C-met、EGFR、HER2、Ki-67、MMP7、P53及TOPOⅡ的表达情况.应用RECIST l.1标准和病理组织学相结合做化疗疗效评估,单因素和logistic多因素回归分析各指标与化疗疗效的关系.结果 本组患者新辅助化疗总有效率为52.8％(28/53),其中部分缓解52.8％ (28/53),疾病稳定45.3％(24/53),疾病进展1.9％(1/53).新辅助化疗前后各因子表达差异无统计学意义(P＞0.05).HER2阳性表达者化疗有效率(完全缓解加部分缓解)为83.3％(10/12),阴性表达者化疗有效率为43.9％(18/41),两者比较差异有统计学意义(P=0.016).P53阳性表达者化疗有效率为35.7％(10/28),明显低于阴性表达者的72.0％(18/25,P=0.008).HER2阳性表达同时P53阴性表达者6例,其化疗均为有效.C-met、EGFR、Ki-67、MMP7及TOPOII的表达与化疗敏感性无关(P＞0.05).多因素分析显示,HER2和P53是新辅助化疗的独立影响因素(P＜0.05).结论 HER2和P53的表达情况对mFOLFOX7方案新辅助化疗疗效的预测有重要价值,推断两者可作为独立的影响因子在化疗前进行疗效预测.
目的 探討7種胃癌相關因子在mFOLFOX7方案新輔助化療治療進展期胃癌療效中的預測價值.方法 選取2009年8月至2011年8月間收治的53例行mFOXFOL7方案(氟尿嘧啶、奧沙利鉑加亞葉痠鈣)新輔助化療的Ⅱ～Ⅲ期胃癌病例,採用免疫組織化學方法檢測腫瘤組織中C-met、EGFR、HER2、Ki-67、MMP7、P53及TOPOⅡ的錶達情況.應用RECIST l.1標準和病理組織學相結閤做化療療效評估,單因素和logistic多因素迴歸分析各指標與化療療效的關繫.結果 本組患者新輔助化療總有效率為52.8％(28/53),其中部分緩解52.8％ (28/53),疾病穩定45.3％(24/53),疾病進展1.9％(1/53).新輔助化療前後各因子錶達差異無統計學意義(P＞0.05).HER2暘性錶達者化療有效率(完全緩解加部分緩解)為83.3％(10/12),陰性錶達者化療有效率為43.9％(18/41),兩者比較差異有統計學意義(P=0.016).P53暘性錶達者化療有效率為35.7％(10/28),明顯低于陰性錶達者的72.0％(18/25,P=0.008).HER2暘性錶達同時P53陰性錶達者6例,其化療均為有效.C-met、EGFR、Ki-67、MMP7及TOPOII的錶達與化療敏感性無關(P＞0.05).多因素分析顯示,HER2和P53是新輔助化療的獨立影響因素(P＜0.05).結論 HER2和P53的錶達情況對mFOLFOX7方案新輔助化療療效的預測有重要價值,推斷兩者可作為獨立的影響因子在化療前進行療效預測.
목적 탐토7충위암상관인자재mFOLFOX7방안신보조화료치료진전기위암료효중적예측개치.방법 선취2009년8월지2011년8월간수치적53례행mFOXFOL7방안(불뇨밀정、오사리박가아협산개)신보조화료적Ⅱ～Ⅲ기위암병례,채용면역조직화학방법검측종류조직중C-met、EGFR、HER2、Ki-67、MMP7、P53급TOPOⅡ적표체정황.응용RECIST l.1표준화병리조직학상결합주화료료효평고,단인소화logistic다인소회귀분석각지표여화료료효적관계.결과 본조환자신보조화료총유효솔위52.8％(28/53),기중부분완해52.8％ (28/53),질병은정45.3％(24/53),질병진전1.9％(1/53).신보조화료전후각인자표체차이무통계학의의(P＞0.05).HER2양성표체자화료유효솔(완전완해가부분완해)위83.3％(10/12),음성표체자화료유효솔위43.9％(18/41),량자비교차이유통계학의의(P=0.016).P53양성표체자화료유효솔위35.7％(10/28),명현저우음성표체자적72.0％(18/25,P=0.008).HER2양성표체동시P53음성표체자6례,기화료균위유효.C-met、EGFR、Ki-67、MMP7급TOPOII적표체여화료민감성무관(P＞0.05).다인소분석현시,HER2화P53시신보조화료적독립영향인소(P＜0.05).결론 HER2화P53적표체정황대mFOLFOX7방안신보조화료료효적예측유중요개치,추단량자가작위독립적영향인자재화료전진행료효예측.
Objective To investigate the predictive value of seven gastric cancer-associated factors on neoadjuvant chemotherapy in patients with advanced gastric cancer.Methods Expressions of C-met,EGFR,HER2,Ki-67,MMP7,P53 and TOPOII were detected by immunohistochemistry in gastric cancer tissues of 53 cases before and after mFOLFOX7 neoadjuvant chemotherapy.Chemotherapy efficacy was evaluated according to RECIST 1.1 standard combined with histopathology,and the relationship between various genes and chemotherapy efficacy was analyzed by univariate and logistic multivariate regression analyses.Results The clinical response rate was 52.8％(28/53) in neoadjuvant chemotherapy,including complete response in none,partial response in 28 cases(52.8％),stable disease in 24 cases(45.3％) and progressive disease in 1 case(1.9％).The expressions of all the genes were not significantly different before and after neoadjuvant chemotherapy (P＞0.05).Neoadjuvant chemotherapy efficacy was 83.3％(10/12)in the patients of HER2 positive expression and 43.9％(18/41) in the patients of HER2 negative expression.The former was significant higher than the latter (P=0.016).Response rate of patients with P53 positive expression was 35.7％ (10/28),significantly lower than 72.0％(18/25) of those with P53 negative expression (P=0.008).Six patients with both HER2 positive expression and P53 negative expression showed better efficacy.The expressions of C-met,EGFR,Ki-67,MMP7 and TOPO Ⅱ were not associated with response to neoadjuvant chemotherapy(P＞ 0.05).HER2 and P53 were independent influencing factors of neoadjuvant chemotherapy (P＜0.05).Conclusion Expressions of HER2 and P53 have great value in the prediction of mFOLFOX7 neoadjuvant chemotherapy efficacy,suggesting that as independent factors,HER2 and P53 may be used to predict the efficacy before chemotherapy.
