HER-2、贫血和前白蛋白与胃癌预后的关系

目的研究HER-2、术前贫血和前白蛋白水平与胃癌预后的关系。方法对2008年1月-2009年12月经手术病理确诊、有完整随访资料的103例Ⅲ～Ⅳ期胃癌患者进行回顾性分析。选择性别、年龄、组织学类型、肿瘤部位、肿瘤大小、浸润深度、临床分期、HER-2、术前血红蛋白和血清前白蛋白水平作为观察指标。采用Kaplan-Meier生存分析、Log rank 检验和Cox 比例风险模型进行单因素和多因素分析；组间变量采用χ²检验或Fisher's精确检验。结果单因素分析显示N分期、HER-2、贫血、临床分期、前白蛋白水平均与胃癌的预后显著相关(P<0.05)；年龄、性别、肿瘤大小和部位与胃癌生存无相关性。Cox多因素分析显示HER-2过表达、贫血、白蛋白水平和临床分期是影响胃癌预后的独立因素(P<0.05)。结论（1）临床分期、HER-2、贫血和前白蛋白是胃癌的独立预后因素; （2）淋巴结转移与胃癌预后相关，但不是独立预后因素。（3）贫血的构成比与HER-2状态及临床分期有关，与前白蛋白无关。

Relationship between HER-2, Anemia, Prealbumin and Prognosis of Gastric Cancer

ObjectiveTo investigate the relationship between HER-2, anemia , prealbumin and the prognosis of gastriccancer.MethodsOne hundred and three patients diagnosed as primary gastric cancer and staged at Ⅲ-Ⅳ from 2008to 2009 were retrospectively analyzed. The clinical characteristics such as age, gender,histological type, tumor location, tumor size, infiltration depth, lymph node metastasis, clinicalstage, the expression of HER-2, anemia and prealbumin concentration were observed. Survival curveswere drawn with the Kaplan-Meier analysis. Comparisons were made with the Log rank test. Coxproportion risk model was established and χ²-test or Fisher's exact probability testwas used to compare clinical characteristics.ResultsLymph node metastasis, clinical stage, the expression of HER-2, anemia and prealbumin wereidentified as influencing factors about the prognosis of gastric cancer, while age, gender,histological type, tumor location and size were irrelevant with the survival of tumor patients.Multiple logistic regression analysis showed that independent and significant factors associatedwith the prognosis of gastric cancer were clinical stage, the expression level of HER-2, anemia andprealbumin concentration(P<0.05).Conclusion（1）HER-2 over-expression, anemia and low prealbumin concentration are the independent andsignificant factors on the prognosis of gastric cancer.（2）Lymph node metastasis is the influencing but not the independent factor on the prognosis ofgastric cancer.（3）There is a significant difference on the proportion of anemia between HER-2 positive group and negative group, and the same result is found in stage Ⅲ group and stage Ⅳ group but not in prealbumin groups.