胃癌原发灶和淋巴结转移灶HER2表达的临床意义

目的 观察HER2在胃癌原发灶和淋巴结转移灶中的表达及其临床意义.方法 选取胃癌患者140例,其中淋巴结转移94例.采集胃癌患者的原发灶、淋巴结转移灶及癌旁组织,采用免疫组织化学法(Elivision)方法检测3种组织中HER2蛋白表达情况.结果 140例胃癌原发灶组织中HER2蛋白阳性表达与胃癌TNM分期、浸润深度及淋巴结转移有关(P<0.05),而与患者性别、年龄和分化程度无关(P>0.05),癌旁组织中HER2表达与性别、年龄、分化程度、TNM分期、浸润深度及淋巴结转移均无关(P>0.05);HER2蛋白在胃癌原发灶、淋巴结转移灶中表达水平均高于癌旁组织,差异有统计学意义,而94例淋巴结转移灶和对应的胃癌原发灶中HER2表达的差异无统计学意义;94例有淋巴结转移的患者淋巴结转移灶与原发灶HER2表达一致率为89.4%,两类标本HER2表达状态具有一致性(Z=6.386,P<0.001).结论 胃癌HER2蛋白的阳性表达与胃癌TNM分期、浸润深度及淋巴结转移有关,提示HER2的表达与胃癌的浸润转移有关;胃癌原发灶和淋巴结转移灶HER2的表达具有较好的一致性,患者在不能获取原发病灶的情况下,检测转移灶中HER-2可能为靶向治疗的选择提供依据,为晚期胃癌患者带来希望.

Clinical Significance of HER2 Expression in Primary Gastric Cancer and Lymph Node Metastasis

Objective To investigate the expression of HER2 in primary gastric carcinoma and lymph node metastasis and its clinical significance.Methods 140 patients with gastric cancer,including 94 cases of lymph node metastasis,were selected.The primary foci,lymph node metastasis and adjacent tissues of gastric cancer patients were collected .The expression of HER2 protein in 3 tissues was detected by immunohistochemistry (Elivision).Results 140 cases of primary gastric cancer tissues,the positive expression of HER2 protein was related with TNM staging,depth of invasion and lymph node metastasis (P <0.05),but not with gender,age and degree of differentiation(P >0.05),paracancerous tissue HER2 expression was not related with gender,age,degree of differentiation,TNM stage,invasion depth and lymph node metastasis (P >0.05);the expression of HER2 protein in primary gastric carcinoma and metastatic lymph nodes in level were higher than the adjacent tissues ,the difference was statistically significant,and 94 cases of gastric cancer,lymph node metastasis and corresponding primary foci of HER 2 expression difference was statistically significant;94 cases with lymph node node metastasis node metastasis and primary tumor HER 2 expression rate was 89.4%,the 2 tissues were consistent with the expression of HER2(Z =6.386,P <0.001).Conclusion The positive expression of HER2 protein in gastric cancer is related with TNM staging,depth of invasion and lymph node metastasis ,suggesting that HER2 expression is related with invasion and metastasis of gastric cancer ;expression of primary tumor and lymph node metas -tasis of HER2 have good consistency,the patients obtain primary lesions in the case of not detecting metastases HER -2 may provide the basis for targeted treatment of choice,and hope for patients with advanced gastric cancer .