血清cfDNA水平与HER2阴性胃癌化疗疗效的相关性研究-东南大学学报医学版

血清cfDNA水平与HER2阴性胃癌化疗疗效的相关性研究

单位：1. 徐州医科大学附属连云港医院病理科, 江苏连云港 222000;
2. 徐州医科大学附属连云港医院肿瘤科, 江苏连云港 222000;
3. 徐州医科大学附属连云港医院精准医学实验室, 江苏连云港 222000

分类号：R735.2

出版年·卷·期（页码）：2020·39·第六期（826-830）

摘要：

目的：研究血清循环游离脱氧核糖核酸（cfDNA）水平与人类表皮生长因子受体2（HER2）阴性胃癌化疗疗效的相关性。方法：以我院2018年1月至2019年5月收治的60例不能手术的Ⅲ~Ⅳ期HER2阴性单纯化疗的胃癌患者为研究对象，化疗方案为奥沙利铂联合替吉奥（奥沙利铂130 mg·m^-2静脉滴注，第1天，替吉奥40 mg·m^-2口服，每天2次，第1~14天，每21 d重复）。每化疗2个周期后评估疗效，评估标准根据实体瘤疗效的评价标准（RECIST 1.1版），直至疾病进展或患者死亡。另选我院同期体检正常者60例为对照组，比较两组血清cfDNA水平之间的差异，分析治疗组患者的血清cfDNA水平与化疗疗效、组织分化程度、有无淋巴结转移、TNM分期、有无远处转移之间的相关性。结果：胃癌患者的血清cfDNA水平显著高于对照组（P<0.05）；不同性别、年龄患者的血清cfDNA水平差异无统计学意义（P>0.05）；组织分化程度、有无淋巴结转移、TNM分期、有无远处转移患者血清cfDNA差异具有统计学意义（P<0.05）；客观有效患者的血清cfDNA水平显著低于客观无效患者（P<0.05）。结论：血清cfDNA水平可方便且无创地预测HER2阴性胃癌患者化疗疗效和预后，从而可帮助临床医生及时调整和更换化疗方案，使治疗更为合理、科学和有效。

Objective: To study the relationship between serum cfDNA and the efficacy of chemotherapy for HER2-negative gastric cancer. Methods: 60 cases of stage Ⅲ-Ⅳ HER2-negative gastric cancer patients treated solely with chemotherapy in Xuzhou Medical University Affiliated Hospital of Lianyungang between January 2018 and May 2019 were enrolled in our study. The chemotherapy regimen was oxaliplatin combined with tegafur(oxaliplatin 130 mg·m^-2 intravenous infusion D1, tegafur 40 mg·m^-2 oral, 2 times·d^-1, D1-14, repeated every 21 days). The treatment efficacy was assessed after every two cycles of chemotherapy according to the efficacy evaluation criteria for solid tumors(RECIST version 1.1) until disease progression or decease. In addition, 60 patients with normal physical examination results in our hospital during the same period were selected as the control group. The correlation between serum cfDNA and chemotherapy efficacy, tissue differentiation, lymph node metastasis, TNM stage and distant metastasis were analyzed. Results: Serum cfDNA levels in patients with gastric cancer were significantly higher than those of the control group(P<0.05); the differences in serum cfDNA levels among patients of different gender and age groups were not statistically significant(P>0.05). The degree of tissue differentiation, the presence of lymph node metastasis, TNM staging, and whether the difference in serum cfDNA of patients with distant metastasis were statistically significant(P<0.05); the serum cfDNA levels of objectively effective patients were significantly lower than those of objectively ineffective patients(P<0.05). Conclusion: Serum cfDNA level can be used to conveniently and noninvasively predict the efficacy and prognosis of chemotherapy in patients with HER2-negative gastric cancer.

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