HER-2表达与胃癌Lauren分型临床病理特征及预后的研究

发布时间：2018-03-20 01:35

  本文选题：胃肿瘤　切入点：Lauren分型　出处：《皖南医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本文通过免疫组化(immunohistochemistry,IHC)以及荧光原位杂交(fluorescence in situ hybridization,FISH)方法检测人类表皮生长因子受体2(human epidermal growth factor receptor-2,HER-2)在不同Lauren分型胃癌患者中的表达情况,分析研究HER-2表达情况与不同胃癌患者的临床病理特征以及预后关系,以期对指导不同胃癌患者的治疗起到个体化帮助作用。方法:收集2012年3月至2013年12月在皖南医学院第一附属医院经诊治并且病理证实为胃癌的276例患者的病理资料,并对其进行回顾性分析。通过IHC以及FISH技术判定所有不同患者胃癌组织中的HER-2表达情况,分析研究HER-2表达情况与不同胃癌患者临床病理特征及预后的关系,包括与不同Lauren分型胃癌患者的临床病理特征之间的关系。结果:将276例不同Lauren分型胃癌患者的蜡块标本按照IHC方法联合FISH方法测定其HER-2的表达状况,阳性率为16.7%(46/276)。HER-2阳性胃癌患者与HER-2阴性者在肿瘤最大径、T分期、N分期、TNM分期以及Lauren分型方面的差异均有统计学意义(P0.05)。HER-2阳性胃癌患者的肿瘤最大径≥4cm的患者比例高于HER-2阴性者(67.4%/50%,P=0.031);HER-2阳性胃癌患者的浸润深度未突破脏层腹膜的患者比例显著低于HER-2阴性者(19.6%/56.5%),而侵及浆膜外的比例显著高于HER-2阴性者(80.4%/43.5%);HER-2阳性胃癌患者无淋巴结转移比例显著低于HER-2阴性者(15.2%/43.9%);HER-2阳性胃癌患者TNM分期中,IV期患者比例显著高于HER-2阴性者(19.6%/2.2%)。HER-2表达为阳性的胃癌患者中,Lauren分型为肠型胃癌患者的比例高于弥漫型胃癌患者(80.4%/52.2%,P=0.002)。276例胃癌患者的HER-2阳性率是16.7%(46/276),其中肠型胃癌的HER-2阳性率是23.6%(37/157),而弥漫型胃癌及混合型胃癌患者的HER-2阳性率依次为7.1%(6/84)和8.6%(3/35),三者具有统计学差异(P0.05)。单因素生存分析显示:肿瘤最大径、肿瘤部位、T分期、N分期、TNM分期、Lauren分型以及HER-2状态是影响胃癌患者预后的相关因素。多因素生存分析表明:仅肿瘤部位、T分期、N分期、TNM分期和Lauren分型是胃癌患者预后的独立影响因素。生存函数显示:HER-2阳性的胃癌患者3年生存率低于HER-2阴性者(28.3%/48.7%,χ2=6.603,P=0.01)。结论:HER-2的表达情况与Lauren分型胃癌的临床病理特征及预后关系密切。HER-2阴性的Lauren分型胃癌患者预后要好于HER-2阳性者。
[Abstract]:Objective: to detect the expression of human epidermal growth factor receptor 2human epidermal growth factor receptor-2HER-2 in patients with different Lauren types of gastric cancer by immunohistochemistry and fluorescence in situ hybridization in situ hybridization (fish). To study the relationship between the expression of HER-2 and the clinicopathological features and prognosis of different gastric cancer patients. Methods: from March 2012 to December 2013, we collected the pathological data of 276 patients with gastric cancer who were diagnosed and treated in the first affiliated Hospital of Southern Anhui Medical College and pathologically proved to be gastric cancer. The expression of HER-2 was determined by IHC and FISH techniques, and the relationship between the expression of HER-2 and the clinicopathological features and prognosis of different gastric cancer patients was studied. Results: the expression of HER-2 in 276 cases of gastric cancer with different Lauren typing was determined by IHC combined with FISH method, including the relationship between the clinicopathological features and the clinicopathological characteristics of gastric cancer patients with different Lauren typing. The positive rate of 46 / 276U 路HER-2 positive gastric cancer patients and HER-2 negative patients were significantly higher than those of HER-2 negative patients. There were statistically significant differences in TNM staging and Lauren classification between patients with HER-2 positive gastric cancer and those with positive gastric cancer P0.05. HER-2 positive patients were higher than those with positive gastric cancer patients with tumor maximum diameter 鈮，

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