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血清AFP阳性胃癌中HER2和RRM1的表达及其意义
作者:董志成1 2  刘凌翔1 
单位:1. 南京医科大学第一附属医院 肿瘤科, 江苏 南京 210029;
2. 连云港市第二人民医院 肿瘤科, 江苏 连云港 222000
关键词:甲胎蛋白 胃癌 人表皮生长因子2 核糖核苷酸还原酶M1 
分类号:R735.2
出版年·卷·期(页码):2019·38·第五期(799-805)
摘要:

目的:研究人表皮生长因子2(HER2)和核糖核苷酸还原酶M1(RRM1)在血清AFP阳性胃癌(AFPGC)和普通胃癌之间表达的差异,预测曲妥珠单抗及铂类对AFPGC的疗效。方法:收集AFPGC石蜡标本61例作为实验组,匹配普通胃癌122例作为对照组,以免疫组化法测定HER2和RRM1的表达,比较两组之间表达的差异,并分析其表达与临床病理特征的相关性以及对生存期的影响。结果:HER2在实验组和对照组的阳性表达率分别为45.9%、30.33%,两组的差异有统计学意义(P=0.038);RRM1的阳性表达率分别为44.26%、62.30%,两组的差异有统计学意义(P=0.02)。在实验组中,HER2在Ⅲ期的阳性表达率明显低于Ⅰ~Ⅱ期(P=0.033),RRM1在分化程度<Ⅲ级的阳性率明显高于Ⅲ级(P=0.008)。在总样本中,HER2阳性胃癌患者的生存期明显比阴性者短,差异有统计学意义(P<0.001)。血清AFP水平(P=0.016,RR=1.001)是AFPGC的独立预后因素。结论:AFPGC的HER2阳性表达率明显高于普通胃癌,RRM1阳性表达率明显低于普通胃癌,提示AFPGC可能对曲妥珠单抗及铂类的治疗有更多的获益。

Objective: To study the differences in the expressions of human epidermal growth factor 2(HER2) and ribonucleotide reductase M1(RRM1) between the serum AFP positive gastric cancer(AFPGC) and the common gastric cancer, in order to predict the effect of trastuzumab and platinum on AFPGC. Methods: Sixty-one cases of AFPGC paraffin specimens were chosen as the experimental group, meanwhile 122 cases of normal gastric cancer were chosen as the control group. The expressions of HER2 and RRM1 were detected by immunohistochemistry. The differences in the expressions of them between the two groups were analyzed, also the correlation between their expressions and clinicopathological characteristics or their influences on the survival time were analyzed. Results: The positive expressions of HER2 in the experimental group and the control group were 45.9% and 30.33%, the difference between the two groups was statistically significant (P=0.038);The positive expressions of RRM1 in the two groups were 44.26% and 62.30%,the difference between the two groups was statistically significant (P=0.02). In the experimental group, the positive expression of HER2 in the stage Ⅲ were significantly lower than that in the stage Ⅰ-Ⅱ (P=0.033),meanwhile the positive expression of RRM1 in the grade that less than Ⅲ were significantly higher than that in the grade Ⅲ (P=0.008). In the total samples, the survival time of the HER2 positive gastric cancer were shorter than that of the HER2 negative gastric cancer,the difference was statistically significant(P<0.001). The serum AFP level (P=0.016,RR=1.001) was the independent prognostic factor of AFPGC. Conclusion: The positive expression of HER2 in AFPGC is significantly higher than that of normal gastric cancer, meanwhile the positive expression of RRM1 in AFPGC is significantly lower than that of normal gastric cancer, suggesting that AFPGC may benefit more from the therapy of trastuzumab and platinum.

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