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目的:探讨HER-2在胃癌、癌旁及其淋巴结组织中表达的临床意义,分析HER-2的表达水平与临床病理特征和预后以及原发灶和转移灶之间的关系.方法:应用免疫组化S-P法,采用组织芯片技术,分析189例胃癌、54例癌旁组织、41例淋巴结转移灶及32例正常对照组织中HER-2蛋白表达.结果:胃癌、癌旁和正常胃黏膜HER-2阳性表达率分别是68.8%,25.9%和12.5%.三组之间阳性表达率的差异具有显著性(P<0.05).HER-2阳性表达与有无淋巴结转移、浸润深度、Lauren分型、分化程度有关(P<0.05),与性别、年龄、肿瘤大小无关(P>0.05).41例淋巴结转移灶和相对应的41例胃癌组织HER-2阳性表达率差异具有显著性(P<0.01),HER-2高表达.单因素生存分析显示HER-2阳性组对胃癌患者生存期的影响有统计学意义(P<0.05),Cox多元回归分析显示HER-2的异常表达可作为影响胃癌预后的独立因素(P<0.05).结论:HER-2高表达参与胃癌的发生发展、浸润转移,是胃癌发生的晚期事件.转移灶癌组织和原发灶相比有异质性.HER-2蛋白阳性表达对胃癌患者来说是一个不利的预后因素,而且能作为一个独立的预后指标.
OBJECTIVE: To investigate the clinical significance of HER-2 expression in gastric cancer, paracancer and lymph node tissues, and to analyze the relationship between the expression of HER-2 and the clinicopathological characteristics and prognosis, as well as the primary tumor and metastasis.Methods: SP method and tissue microarray technique were used to analyze HER-2 protein expression in 189 cases of gastric cancer, 54 cases of paracancerous tissues, 41 cases of lymph node metastasis and 32 cases of normal controls.Results: The expressions of HER- 2 positive expression rate was 68.8%, 25.9% and 12.5% respectively.The positive expression rate of the three groups was significantly different (P0.05) .The positive expression of HER-2 was correlated with the lymph node metastasis, the depth of invasion, Lauren’s classification (P <0.05), but not with gender, age and tumor size (P> 0.05) .The positive rate of HER-2 in 41 cases of lymph node metastasis and corresponding 41 cases of gastric carcinoma was significantly different (P < 0.01), HER-2 overexpression.Univariate survival analysis showed that the HER-2 positive group had a significant effect on the survival of gastric cancer patients (P <0.05), Cox multivariate regression analysis showed that the abnormal expression of HER-2 may be affected The independent prognostic factors of gastric cancer (P <0.05) .Conclusion: The high expression of HER-2 is involved in gastric cancer Development, invasion and metastasis, is a late event of gastric cancer .Hematogenous metastasis of cancer tissue compared with the primary heterogeneity.HER-2 protein positive expression of gastric cancer patients is an unfavorable prognostic factor, but also as a Independent prognostic indicators.