黄银梅　吴晓文　蔡东林　马宏武

【摘要】 目的：探讨胃癌HER-2阳性表达的临床病理特征及与胃癌术后辅助化疗效果的相关性。方法：选取2017年1月-2018年1月笔者所在医院47例胃癌切除术后行辅助化疗的患者，回顾性调研两组临床病理资料，比较观察两组无疾病进展生存时间（PFS）与总生存时间（OS），分析HER-2表达与临床指标的相关性。结果：47例患者中，HER-2阳性表达（试验组）24例，HER-2阴性表达（对照组）23例。两组性别、年龄、病变部位、TNM分期比较，差异无统计学意义（P>0.05），试验组Lauren分型肠型占比、肿瘤中分化占比和肿瘤直径5 cm以上病例占比均高于对照组，差异均有统计学意义（P<0.05）。试验组PFS与OS均短于对照组，差异均有统计学意義（P<0.05）。经Pearson相关性分析可知，HER-2表达与肿瘤大小呈正相关，与分型、分化及化疗后生存期呈负相关，差异均有统计学意义（P<0.05）。结论：胃癌HER-2表达与肿瘤大小、分型、分化、化疗后生存期等有关，阳性患者化疗后无疾病进展生存与总生存时间相对要短，获益效果不及阴性患者理想。

【关键词】 胃癌 术后辅助化疗 HER-2表达 疗效 相关性

doi：10.14033/j.cnki.cfmr.2020.21.064 文献标识码 B 文章编号 1674-6805（2020）21-0-03

Correlation Analysis between HER-2 Expression in Gastric Cancer and Curative Effect of Postoperative Adjuvant Chemotherapy/HUANG Yinmei， WU Xiaowen， CAI Donglin， MA Hongwu. //Chinese and Foreign Medical Research， 2020， 18（21）： -158

[Abstract] Objective： To investigate the correlation analysis between HER-2 expression in gastric cancer and curative effect of postoperative adjuvant chemotherapy. Method： From January 2017 to January 2018， 47 patients who underwent adjuvant chemotherapy after gastric cancer resection in our hospital were selected. The clinical and pathological data of the two groups were retrospectively investigated， the disease progression-free survival time （PFS） and total survival time （OS） of the two groups were compared and observed， and the correlation between HER-2 expression and clinical indicators was analyzed. Result： Among the 47 patients， there were 24 patients with positive her-2 expression （experimental group） and 23 patients with negative HER-2 expression （control group）. There were no statistically significant differences in gender， age， lesion site and TNM stage between the two groups （P>0.05）. The proportion of Lauren type intestinal type， proportion of tumor differentiation in the experimental group， and proportion of cases with tumor diameter of more than 5 cm in the experimental group were all higher than those in the control group， the differences were statistically significant （P<0.05）. The PFS and OS in the experimental group were shorter than those in the control group， the differences were statistically significant （P<0.05）. Pearson correlation analysis showed that HER-2 expression was positively correlated with tumor size and negatively correlated with typing， differentiation and survival after chemotherapy， the differences were statistically significant （P<0.05）. Conclusion： Gastric cancer HER-2 expression is related to tumor size， typing， differentiation， survival after chemotherapy. Positive patients have relatively short disease-free survival and overall survival after chemotherapy， and the benefit is less than that of negative patients.

[Key words] Gastric cancer Postoperative adjuvant chemotherapy HER-2 expression Curative effect Correlation

First-authors address： Chaoyang District Dafeng Hospital in Shantou City， Shantou 515154， China

胃癌是常见消化道恶性肿瘤，数据统计我国年新发病例约43万，死亡超30万，均居恶性肿瘤前列。临床治疗胃癌以手术为首选，对于进展期患者术后常辅以化疗，以杀灭残余肿瘤细胞，强化手术治疗效果，延长生存期[1]。但临床实践发现，即使是临床分期相同的胃癌患者，外科术后辅助化疗临床获益也有所差異。近年，随着胃癌分子病因学研究的深入发展，研究发现HER-2基因表达与恶性肿瘤侵袭、转移存在密切相关性，是研究证实的胃癌不良预后标志物[2]。文章现择取笔者所在医院2017年1月-2018年1月收治的胃癌患者47例，分析探讨HER-2基因表达与辅助化疗疗效的相关性，报道如下。

1 资料与方法

1.1 一般资料

从笔者所在医院2017年1月-2018年1月收治的胃癌患者中择取47例为研究对象。纳入标准：病理组织学确诊胃癌;行外科切除手术，术后辅助化疗;接受HER-2基因检测。排除……