人表皮生长因子受体家族在胃癌中表达的临床意义

目的探讨人表皮生长因子受体（HER）家族成员[HERl（EGFR）、HER2、HER3和HER4]在胃癌患者中的表达情况及其与预后的关系。方法回顾性分析2006年1月至2006年12月江苏省肿瘤医院胃肿瘤诊疗中心收治的161例胃癌患者的临床资料，应用免疫组织化学方法判断HER家族成员的表达情况，并对其表达与患者预后情况进行分析。结果161例患者中，HERl高表达者74例（46．0％）；HER2高表达者17例（10．6％）；HER3高表达者90例（55．9％），HER4高表达者110例（68．3％）。单因素分析显示：HER2高表达与肿瘤Lauren分型有关（P〈0．05）；HER3高表达与肿瘤浸润深度、淋巴结转移、肿瘤分期和神经脉管侵犯及预后有关（P〈O．05）；HER4高表达与肿瘤浸润深度和远处转移及肿瘤分期有关（P〈O．05）。HER2-HER3协同高表达与患者预后有关（P=0．023）。多因素分析显示：肿瘤分期和HER3高表达是影响胃癌预后的因素（P〈0．05）。结论HER3有可能成为评价胃癌预后的独立因素。

CHnical significance of human epidermal growth factor receptor family molecules expression in gastric cancer

Objective To study the association of human epidermal growth factor receptor family molecules expression in gastric cancer tissues with the prognosis of patients with gastric cancer. Methods Clinical data of 161 patients with gastric cancer undergoing gastrectomy in Jiangsu Cancer Hospital between January 2006 and January ：2007 were analyzed retrospectively. The expression of HER1, HER2, HER3 and HER4 was detected by immunohistochemistry. Association of the expression of HER family with the prognosis of patients was examined. Kaplan-Meier method was used to analyze the survival. Results High expression rates of HER1, HER2, HER3 and HER4 were 46.0%（74/161 ）, 10.6% （ 17/161 ）, 55.9% （90/161） and 68.3% （ 110/161 ） respectively. Univariate analysis revealed that high expression of HER3 was associated with tumor invasion depth, lymph node metastasis, stage, neurovascular invasion, and overall 4-year survival. High expression of HER4 was associated with tumor distant metastasis and stage. High co-expression of HER2 and HER3 was associated with overall 4-year Survival （P=0.023）. Multivariate analysis revealed that high expression of HER3 and stage were prognostic independent factors. Conclusion Up-regulated expression of HER3 is associated with the poor prognosis in gastric cancer patients.